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Case report
63-year-old man with right biceps and right pectoralis major abscesses: an unusual case of pyomyositis
  1. Sydney Tatsuno1,
  2. Tara Reed1,
  3. Eric Tatsuno2 and
  4. Curtis Lee1
  1. 1Department of Medicine, University of Hawaii at Manoa John A Burns School of Medicine, Honolulu, Hawaii, USA
  2. 2Independent researcher, Honolulu, Hawaii, USA
  1. Correspondence to Dr Sydney Tatsuno; sydtatsuno{at}


Pyomyositis is considered a great mimicker and masquerader. This case is of a 63-year-old man with diabetes who initially presented to the outpatient clinic afebrile with right shoulder pain. His work-up was negative, and he was discharged home. He subsequently presented to the emergency room (ER) two times for worsening right shoulder pain. During his first visit to the ER, his work-up was unremarkable, and he was discharged home. On his return to the ER, he was now febrile with inflammation involving his right upper extremity and right chest wall. Imaging studies of his right upper extremity and his right chest wall were consistent with multiple abscesses. Methicillin resistant Staphylococcus aureus was cultured from the abscess, and from blood and urine cultures. The diagnosis of pyomyositis was confirmed. This case illustrates the difficulty of diagnosing pyomyositis and the importance of including it in the differential diagnosis, especially in an immunocompromised patient.

  • infectious diseases
  • renal medicine
  • general practice / family medicine

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  • Contributors ST and ET drafted the work and were involved in the image selection. CL and TR were involved in the concept and revision of the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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