Acute Proximal Myopathy in a Young Male—A Case of Infectious Myositis
Background and objectives: Acute proximal muscle weakness has a broad differential. Infectious myositis is difficult to differentiate clinically from inflammatory myopathy, often causing a delayed diagnosis. Infectious myositis should be thought of as a differential for proximal muscle pain and weak...
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doaj-9743ee915012453f8c4c21202998416c2020-11-25T02:20:27ZengMDPI AGMedicina1010-660X2019-01-015511910.3390/medicina55010019medicina55010019Acute Proximal Myopathy in a Young Male—A Case of Infectious MyositisRashmi Dhital0Sijan Basnet1Dilli Ram Poudel2Reading Hospital, Tower Health System, West Reading, PA 19611, USAReading Hospital, Tower Health System, West Reading, PA 19611, USAUniversity of Pennsylvania, Philadelphia, PA 19104, USABackground and objectives: Acute proximal muscle weakness has a broad differential. Infectious myositis is difficult to differentiate clinically from inflammatory myopathy, often causing a delayed diagnosis. Infectious myositis should be thought of as a differential for proximal muscle pain and weakness in the right context. Case Presentation: A 40-year-old male with diabetes presented with exquisite pain and weakness of proximal extremities. He denied trauma, recent travel, new medications, or substance use. He denied prior rheumatologic, thyroid, or musculoskeletal disorders. The urine culture revealed staphylococcal infection with negative blood cultures. Rheumatologic and endocrine workups were negative. Random muscle biopsy was negative for inflammatory infiltrate. MRI of thighs and arms showed innumerable foci of nodular and ring enhancement in the proximal muscle groups. The patient noted improvement after about 10 days of antibiotics with complete resolution at 2 months. Discussion and Conclusion: Bacterial myositis is most often due to Staphylococcus aureus (70%) and affects a single muscle. Multifocal abscesses are rare and strongly suggest transient bacteremia. Our patient most likely had transient initiating staphylococcal bacteremia leading to diffuse myositis and hematogenous urinary tract infection (UTI). A delay in treatment can be life-threatening.http://www.mdpi.com/1010-660X/55/1/19infectious myositismyopathy |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Rashmi Dhital Sijan Basnet Dilli Ram Poudel |
spellingShingle |
Rashmi Dhital Sijan Basnet Dilli Ram Poudel Acute Proximal Myopathy in a Young Male—A Case of Infectious Myositis Medicina infectious myositis myopathy |
author_facet |
Rashmi Dhital Sijan Basnet Dilli Ram Poudel |
author_sort |
Rashmi Dhital |
title |
Acute Proximal Myopathy in a Young Male—A Case of Infectious Myositis |
title_short |
Acute Proximal Myopathy in a Young Male—A Case of Infectious Myositis |
title_full |
Acute Proximal Myopathy in a Young Male—A Case of Infectious Myositis |
title_fullStr |
Acute Proximal Myopathy in a Young Male—A Case of Infectious Myositis |
title_full_unstemmed |
Acute Proximal Myopathy in a Young Male—A Case of Infectious Myositis |
title_sort |
acute proximal myopathy in a young male—a case of infectious myositis |
publisher |
MDPI AG |
series |
Medicina |
issn |
1010-660X |
publishDate |
2019-01-01 |
description |
Background and objectives: Acute proximal muscle weakness has a broad differential. Infectious myositis is difficult to differentiate clinically from inflammatory myopathy, often causing a delayed diagnosis. Infectious myositis should be thought of as a differential for proximal muscle pain and weakness in the right context. Case Presentation: A 40-year-old male with diabetes presented with exquisite pain and weakness of proximal extremities. He denied trauma, recent travel, new medications, or substance use. He denied prior rheumatologic, thyroid, or musculoskeletal disorders. The urine culture revealed staphylococcal infection with negative blood cultures. Rheumatologic and endocrine workups were negative. Random muscle biopsy was negative for inflammatory infiltrate. MRI of thighs and arms showed innumerable foci of nodular and ring enhancement in the proximal muscle groups. The patient noted improvement after about 10 days of antibiotics with complete resolution at 2 months. Discussion and Conclusion: Bacterial myositis is most often due to Staphylococcus aureus (70%) and affects a single muscle. Multifocal abscesses are rare and strongly suggest transient bacteremia. Our patient most likely had transient initiating staphylococcal bacteremia leading to diffuse myositis and hematogenous urinary tract infection (UTI). A delay in treatment can be life-threatening. |
topic |
infectious myositis myopathy |
url |
http://www.mdpi.com/1010-660X/55/1/19 |
work_keys_str_mv |
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