Changing spectrum of primary pyomyositis in North India

Recent data have demonstrated the changing epidemiology of primary pyomyositis worldwide. Our hospital-based retrospective study investigated the clinical and microbiological spectrum of primary pyomyositis between 2013 and 2021 in PGIMER (Chandigarh), India. Over a quarter had predisposing conditions, mainly diabetes mellitus and immunosuppressive therapy. Fever, muscle pain, local swelling and breathlessness were the usual presentations, with quadriceps, iliopsoas and gluteal muscles commonly affected. Staphylococcus aureus was the predominant cause, with c.50% methicillin-resistant strains. Almost two-thirds presented with metastatic infection (stage 3 pyomyositis), frequently with septic lung emboli. Patients with methicillin-sensitive and resistant Staphylococcus aureus had a similar incidence of metastatic infection. In-hospital mortality was c.10% and was strongly associated with a high international normalised ratio. Primary pyomyositis remains a significant problem, with a dramatic increase in community-associated methicillin-resistant Staphylococcus aureus.

Automated summary

Recent data revealed the changing epidemiology of primary pyomyositis worldwide. A retrospective study conducted at PGIMER hospital in Chandigarh, India between 2013 and 2021 investigated the clinical and microbiological spectrum of primary pyomyositis. The study found that diabetes mellitus and immunosuppressive therapy were the main predisposing conditions, and the common symptoms included fever, muscle pain, local swelling, and breathlessness. Staphylococcus aureus was the predominant causative pathogen, with approximately 50% being methicillin-resistant strains. Nearly two-thirds of the patients presented with metastatic infection, often accompanied by septic lung emboli. The in-hospital mortality rate was around 10% and was strongly associated with a high international normalized ratio.