Pyomyositis is a purulent infection of skeletal muscle that arises from

hematogenous spread, usually with abscess formation. Staphylococcus aureus is the

most common cause of pyomyositis; it causes up to 90 percent of tropical cases and
up to 75 percent of temperate cases. Pyomyositis presents with fever and pain with
cramping localized to a single muscle group. The disease occurs most often in the
lower extremity (sites include the thigh, calf, and gluteal muscles), but any
muscle group can be involved, including the iliopsoas, pelvic, trunk, paraspinal,
and upper extremity muscles. Pyomyositis can be divided into three clinical stages
[33]: ●Stage 1 is characterized by crampy local muscle pain, swelling, and low-
grade fever. Mild leukocytosis and induration of the affected muscle may be
present. A deep abscess may not be discretely palpable, but the muscle may have a
"woody" texture on palpation. Fluctuation is not present, and aspiration of the
muscle will not yield purulent materia