# Diagnostic and Therapeutic Challenges in Multifocal MRSA Pyomyositis: A Case Report

## TL;DR

This case report highlights the challenges in diagnosing and treating a rare muscle infection in an immunocompromised patient.

## Contribution

The report presents a rare case of multifocal MRSA pyomyositis with septic pulmonary emboli in a high-risk patient.

## Key findings

- The patient required ICU admission and targeted antibiotic therapy for septic shock.
- Image-guided drainage and multidisciplinary care were essential for recovery.
- Early imaging and microbiological testing improved clinical outcomes.

## Abstract

Background: Pyomyositis is a rare bacterial infection of skeletal muscle, historically associated with tropical climates but increasingly observed in temperate areas, particularly among immunocompromised individuals. Its nonspecific early symptoms often overlap with other soft-tissue infections, causing diagnostic delay.

Case Presentation: We report the case of a 64-year-old lumberjack with poorly controlled diabetes and a remote history of lymphoma, who developed multifocal MRSA pyomyositis with septic pulmonary emboli following orthopedic trauma and surgery. The condition rapidly evolved into septic shock requiring ICU admission, targeted antibiotic therapy, and multiple image-guided drainages. The patient progressively recovered and was discharged to rehabilitation on Postoperative Day 45.

Conclusion:Pyomyositis should be considered in immunocompromised patients presenting with localized pain, systemic symptoms, and recent trauma. Early imaging, microbiological confirmation, and multidisciplinary management are critical for improving outcomes.