• Rebecca J Zadroga, Dylan Zylla, Kelly Cawcutt, Daniel M Musher, Pankaj Gupta, Michael Kuskowski, Ayse Dincer, and Anjum S Kaka.
• Department of Medicine, VA Medical Center, Minneapolis, Minnesota, USA.
• Clin. Infect. Dis. 2012 Aug 1; 55 (3): e12-7.

AbstractStreptococcus pneumoniae is an uncommon cause of pyomyositis. It is unclear whether the clinical presentation and outcome of pneumococcal pyomyositis differ depending on the host's underlying immune status. We describe 2 patients with pneumococcal pyomyositis, review all published cases, and compare characteristics between apparently healthy hosts and at-risk hosts. A total of 35 cases of pneumococcal pyomyositis were identified, 11 in apparently healthy hosts and 24 in at-risk hosts. Two-thirds of the patients had an antecedent respiratory illness or meningitis. At-risk hosts tended to have a longer interval between the development of symptomatic muscle infection and the diagnosis of pyomyositis and a significantly higher risk of disseminated disease at presentation, as manifested by involvement of multiple noncontiguous muscles or presence of meningitis. Overall, other than 1 death, all patients recovered with antibiotics and surgical drainage, but as might be expected there was a significantly higher rate of complications among at-risk hosts.

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