Pyomyositis and Tropical pyomyositis:
Features:
- Very debilitated patients in ICU or tropical form
- Acute, spontaneous i.e. non-traumatic suppurative infection, abscess formation
Gas gangrene, Clostridium perfringens
Diagnosis:
- Traumatic or surgical. Also spontaneous gas gangrene Clostridium septicum in colon cancer patients.
- Gram stain of bullae fluid: gram positive rods
- Tissue biopsy may be necesary to confirm the diagnosis
Investigations to consider:
Blood tests:
- ABG: metabolic acidosis
- FBC: anemia, hemolysis, thrombocytopenia
- Basic metabolic panel: hyperkalemia.
- LFTs: hyperbilirubinemia. Raised enzymes
- Coagulation: abnormal.
- Blood cultures
Myoglobinuria