Pyomyositis in HIV-infected patients: A difficult diagnosis

Pyomyositis (an abscess of the skeletal muscle) is an uncommon condition in human immunodeficiency virus infected (HIV-infected) patients. This report describes six patients with HIV-associated pyomyositis managed at two HIV/AIDS treatment centres. All patients had low CD4 counts and AIDS. The diagnosis was difficult and often delayed because early symptoms and signs were non-specific. The organism identified in all cases was Staphylococcus aureus. Although most of the abscesses were initially drained percutaneously, four of the six patients required open surgical drainage before the infection resolved. Pyomyositis should be considered in an HIV-infected patient with fever and muscle pain.