The pyomyositis is a primary pyogenic myositis of striated muscle.
The staphylococcus is the main etiological agent,
however recently there have been reports of unusual bacteria,
such as pneumonie streptococcus.
It is common to find such infection in lower trunk and limbs,
but it is unusual to see it in the neck muscles.
Cervical condition described in 0.5 to 4% of cases,
frequently associated with dental problems,
tonsil infection or trauma.
There are 2 types,
tropical and non-tropical.
Is endemic in tropical countries,
but there are reports worldwide.
S.
aureus causes 90% of tropical cases and 75% of non-tropical.
The second most common germ is streptococcus group A.
Other bacteria include Neisseria,
Haemophilus,
Pseudomonas,
Klebsiella,
fungi and anaerobic microorganisms,
but are rare.
In HIV patients the most frequent cause is staphylococcus,
Bartonella and Salmonella.
The pyomyositis most often affects immunosuppressed patients,
but it can affect immunocompetent,
even without risk factors.
Many conditions,
such as deep vein thrombosis,
cellulitis,
muscle contusion,
hematoma,
muscle or tendon rupture,
septic arthritis,
osteomyelitis,
different musculoskeletal tumors,
polymyositis,
leptospirosis,
may often have presentations like to pyomyositis.
Then you should have a high clinical suspicion whenever patients presented with fever and pain in the neck,
whether or not impossibility swallow.
The initial diagnosis approach may be ultrasound,
but CT is the best imaging method for diagnosis,
and if complications are suspected to be passed to MR.
The empirical antibiotic treatment will target initially oxacillin gram-positive cocci,
taking into account risk factors for MRSA and other comorbidities of the patient,
when the abscess has formed,
surgical drainage is essential for healing.The intravenous treatment is 7 to 10 days,
then oral until completion of 5 to 6 weeks.