meropenem and Pyomyositis

Pyomyositis in the neck has rarely been described. We present the sonographic findings in a case of pyomyositis of the sternocleidomastoid muscle. A 62-year-old man with poorly controlled diabetes presented with an induration of the neck and fever. On gray-scale sonography, a part of the sternocleidomastoid muscle appeared swollen and contained irregularly shaped hypoechoic areas. Power Doppler imaging showed increased vascularity in the muscle. Sonographic-guided aspiration confirmed abscesses in the sternocleidomastoid muscle. Surgical drainage was successfully performed along with antibiotic treatment. © 2016 Wiley Periodicals, Inc. J Clin Ultrasound 45:520-523, 2017.

Topics: Anti-Bacterial Agents; Drainage; Humans; Male; Meropenem; Middle Aged; Neck Muscles; Pyomyositis; Thienamycins; Treatment Outcome; Ultrasonography; Vancomycin

Thyroid abscess is a very rare clinical condition. It usually occurs in immunocompromised individuals or those with underlying malignancy. We report a case of multiple thyroid abscesses in the patient with Pre B acute lymphoblastic leukaemia which developed secondary to hematogenous spread from pyomyositis of right calf muscle. The patient developed sepsis-associated disseminated intravascular coagulation, which got resolved after thyroidectomy. He became afebrile after surgical intervention. Unfortunately, all the cultures were negative. Since there are few case series and reports, there are no clear guidelines for management of thyroid abscess. We conclude that though rare, thyroid abscess may be the cause of persistent fever in immunocompromised patients.

Topics: Abscess; Adolescent; Anti-Bacterial Agents; Antineoplastic Combined Chemotherapy Protocols; Clindamycin; Drainage; Fever; Humans; Male; Meropenem; Precursor B-Cell Lymphoblastic Leukemia-Lymphoma; Prednisolone; Pyomyositis; Sepsis; Teicoplanin; Thienamycins; Thyroid Diseases; Thyroid Gland; Thyroidectomy; Treatment Outcome

Primary pyomyositis is a subacute deep bacterial infection of skeletal muscle. It is typically seen in tropical countries with Staphylococcus aureus being the commonest pathogen. Immunocompromised states and trauma are associated with cases in temperate climates where there is an increasing incidence, typically in children and young adults. However, the authors present a case of primary pyomyositis in a previously healthy 80-year-old female. The authors highlight the potential difficulties in early diagnosis of this rare condition in the UK indicating the need for early MRI imaging and the low sensitivity of blood cultures and serum creatine kinase measurements. Treatment, including early surgical drainage and appropriate antibiotic therapy, is discussed.

Topics: Aged, 80 and over; Anti-Bacterial Agents; Biopsy; Female; Humans; Knee; Magnetic Resonance Imaging; Meropenem; Muscle, Skeletal; Pyomyositis; Risk Factors; Thienamycins; United Kingdom

The authors report a rare case of piriformis pyomyositis, in a teenage rugby player, who was initially feverish and presented to us with low back pain, sciatica and inability to mobilise due to pain. Subsequent imaging investigations (MRI scan) revealed abscess formation in the piriformis muscle with compression effect on the ipsilateral sciatic nerve. A course of intravenous antibiotic therapy followed by oral antibiotics fully resolved his symptoms and returned inflammatory markers back to normal.

Topics: Abscess; Adolescent; Anti-Bacterial Agents; Floxacillin; Football; Humans; Low Back Pain; Magnetic Resonance Imaging; Male; Meropenem; Pain; Piriformis Muscle Syndrome; Pyomyositis; Rifampin; Sciatica; Staphylococcal Infections; Staphylococcus aureus; Thienamycins; Vancomycin

Pyomyositis is an infection of skeletal muscle that involves the formation of intramuscular abscesses. It occurs most commonly in immunocompromised patients. Pyomyositis caused by extended-spectrum beta-lactamase (ESBL)-producing Escherichia coli has never been reported in the literature. A 48-year-old female patient developed ESBL-producing E. coli bacteremia and pyomyositis on the twelfth day of cefpirome therapy for neutropenic fever after chemotherapy due to acute myeloid leukemia. She recovered completely after a three-week course of meropenem and surgical excision. Pyomyositis should be included in the differential diagnosis when fever and muscular swelling develop in a patient with neutropenic status after chemotherapy. Early recognition of symptoms and proper diagnostic procedures are key to diagnosing pyomyositis. Both adequate antibiotics and surgical intervention are important for the successful treatment of pyomyositis caused by ESBL-producing E. coli.

Topics: Anti-Bacterial Agents; Antineoplastic Agents; Bacteremia; beta-Lactamases; Drug Resistance, Bacterial; Escherichia coli; Escherichia coli Infections; Female; Humans; Leukemia, Myeloid, Acute; Meropenem; Middle Aged; Pyomyositis; Thienamycins