Thigh pyomyositis caused by group A streptococcus in an immunocompetent adult without any cause

Abstract

BackgroundPyomyositis is typically caused by Staphylococcus aureus, and is rare in temperate climates, although its prevalence has been recently increasing. This infection often involves the thigh, and is associated with immunodeficiency.Case presentationWe report the case of a healthy 20-year-old Japanese woman who experienced a fever and continuous pain for several days. She was admitted to our hospital and was diagnosed with pyomyositis after we discovered an abscess between the muscles of her dorsal distal left thigh using computed tomography. This is a rare case of thigh pyomyositis, as it was caused by group A streptococcus and occurred in an immunocompetent adult from a temperate climate.ConclusionsOur review of the literature revealed that group A streptococcus pyomyositis typically occurs in temperate climates, among young adults without any underlying disease, and is associated with a poorer prognosis, compared to general pyomyositis. We suggest that pyomyositis should be considered when immunocompetent adults present with apparently idiopathic inflammatory muscle lesions.

Severe Lactational Mastitis With Complicated Wound Infection Caused by Streptococcus pyogenes

“…Less common than the superficial disease in GAS is invasive disease that can lead to cellulitis and bacteremia as well as abscess formation, arthritis, meningitis, osteomyelitis, and others (Walker et al, 2014). A Japanese researcher reported a case of GAS as a rare cause for idiopathic pyomyositis (Minami et al, 2017). Researchers have described the relationship of intracranial abscesses in children and GAS (Hazan et al, 2018; Link-Gelles et al, 2020).…”

Extensive pyomyositis of vastus muscles

“…Our patient had a less typical presentation of pyomyositis without pyrexia. The insidious onset of symptoms with only pain without fever rendered the clinical diagnosis challenging and easily missed out [ 2 ]; which happened in the first two consults. Physicians need to note that any infection, including bacteremia can present in the absence of fever.…”

“…Impaired tissue perfusion and impaired chemotaxis, phagocytosis and bactericidal activity of neutrophils are some of the known mechanism of defective immune defense among diabetics. Other predisposing factors for pyomyositis is immune-related conditions such as use of corticosteroids, human immunodeficiency syndrome, malignancies and intravenous drug abusers [ 2 , 8 – 10 ]. There are three stages of evolution of pyomyositis: the invasive stage, purulent stage and late stage.…”

“…Increased in reports from temperate regions could be due to combination factors of increased awareness, improvement in diagnosis and increased in the number of immune-compromising conditions. Pyomyosistis is most commonly caused by Staphylococcus aureus (90%) followed by Group A Streptococci (1-5%) [ 2 ]. Other rarer organisms implicating pyomyositis are Streptococcus (group B, C, G), pneumococcus, Neisseria spp, Haemophilus spp, Aeromonas spp, Klebsiella spp, Yersenia spp, Pseudomonas spp and Escherichia spp [ 3 , 4 ].…”

From a Machine Saw to a Case of Mycobacterium Fortuitum Pyomyositis

“… 2 Most common organisms involved in causing pyomyositis are Staphylococcus aureus (90%) and Group A Streptococci (1%-5%). 3 Less common organisms indicating pyomyositis include other strains of Streptococcus (group B, C, G), Pneumococcus , Neisseria spp , Haemophilus spp , Aeromonas spp , Klebsiella spp , Yersinia spp , Pseudomonas spp , and Escherichia spp . 4 , 5 The true incidence of Mycobacterium fortuitum pyomyositis is unknown, but it has been estimated to be between 4 and 6 cases per million people.…”