Pyomyositis is an acute bacterial infection involving one or multiple striated muscles, potentially leading to abscess formation. Albeit being uncommon, its consequences for the patient can be severe, even fatal. Primarily described in tropical countries, this condition may also occur in temperate regions. Its pathophysiology is still poorly understood. The initiating process could be a minor muscle traumatism followed by bacterial hematogenous colonization of the muscle. Generally, its clinical presentation is insidious and unspecific, its diagnosis being challenging for the clinician. Nevertheless, a rapid diagnosis allows an early antibiotherapy to be established and complications to be prevented. The cornerstone of pyomyositis diagnosis is magnetic resonance imaging (MRI), along with bacterial cultures from biological fluids. The main bacteria involved in this condition is Staphylococcus aureus (SA), while Panton-Valentine leucocidin (PVL) is a toxin secreted by SA. This toxin is reported to be a virulence factor in invasive SA infections, whereas its precise role is still controversial depending on the infection site. We herein present a case of pyomyositis caused by Panton-Valentine leukocidin-secreting SA, with abdominal wall involvement, in a 1-year-old boy from a tropical country who was spending his holiday in Belgium.
Key Words
Pyomyositis, Staphylococcus aureus, Panton-Valentine leucocidin, pediatric infection
What is already known about the topic?
- Pyomyositis is an acute bacterial infection involving one or multiple striated muscles, with potentially severe consequences. Its clinical presentation is insidious and unspecific.
- It mainly affects the muscles of the lower limb.
What does this article bring up for us?
- The incidence of this well-known tropical disease is increasing in the temperate zone.
- Panton-Valentine leucocidin (PVL) toxin is a SA virulence whose precise role is still poorly understood.
- The clinical presentation of pyomyositis may be unusual and mimic other conditions.