Primary pyomyositis and disseminated septic pulmonary emboli: a reactivated staphylococcal infection?

[pyomyositis]

Staphylococcal pyomyositis is a severe invasive soft tissue infection with high mortality rate that is increasingly being recognized even in temperate climates . In most cases predisposing factors are identified that include either source of skin penetration or /and impaired host immunocompetence . A case of primary , community-acquired pyomyositis of the left iliopsoas muscle in a 59 -year -old immunocompetent woman , which was complicated with septic pulmonary emboli within 24 h after hospital admission , is presented . The patient was subjected to abscess drainage under computed tomography guidance . Both pus aspiration and blood cultures revealed methicillin-susceptible Staphylococcus aureus . Given the absolute absence of predisposing factors and a remote history of staphylococcal osteomyelitis in the same anatomical region 53 years ago , reactivation of a staphylococcal soft tissue infection was postulated . Systematic review of the literature revealed a few interesting cases of reactivated staphylococcal infection after decades of latency , although the exact pathophysiological mechanisms still need to be elucidated .