Drugs, muscle pallor, and pyomyositis.

[pyomyositis]

A 33 -year -old athletic male was unexpectedly found dead in his bed . For several days prior to his death he complained of tenderness and swelling of his right buttock . The post-mortem examination revealed unilateral pale gluteal muscles and pustular impetiginized skin lesions of the right lower leg . The muscle histology demonstrated pronounced acute inflammation and limited necrosis of muscle fibers confined to the right gluteal muscles . Vascular occlusion and renal abnormalities were excluded by post-mortem angiography and histology respectively , and the diagnosis of non-tropical pyomyositis , possibly originating from the dermatological infection , was made . Toxicological testing revealed a potentially lethal intoxication with fentanyl and morphine . Pyomyositis is etiologically attributed to an infection and predominantly affects large limb or trunk muscles . Males are affected more frequently than females . Histologically , it is dominated by acute inflammatory infiltrates and may lead to sepsis and subsequent death . Although occurring less frequently , pyomyositis must be considered in the differential diagnosis of macroscopic localized muscle pallor , together with vascular occlusion and rhabdomyolysis . In such cases , only the examination of fresh frozen muscle tissue samples from different locations , together with the histological examination of the internal organs , particularly the kidneys , will facilitate the confirmation of the correct diagnosis .

Diseases
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Diseases presenting "limited necrosis of muscle fibers confined to the right gluteal muscles" symptom

pyomyositis

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