Pyomyositis, a suppurative infection of skeletal muscle, is a disease not frequently encountered by neurosurgical providers. While previously considered an infection localized to tropical and semitropical locations, clinical reports of pyomyositis in temperate climates have increased over the past decade. Paraspinal involvement is uncommon in pyomyositis; however, the potential exists for spread into the epidural space resulting in a spinal epidural abscess (SEA). Early diagnosis of an SEA is frequently hampered by the absence of specific signs, unfamiliarity with the disease, atypical manifestations, and a broad differential diagnosis that includes more common causes of back pain. To date, 1 such case of paraspinal pyomyositis associated with an SEA has been reported in the neurosurgical literature. The authors present 2 cases of pyomyositis with an SEA and review the epidemiology, pathophysiology, diagnostic workup, and management of this disorder.
Abbreviations used in this paper: MRSA = methicillin-resistant Staphylococcus aureus; PCP = primary care provider; SEA = spinal epidural abscess.
Address correspondence to: Jonathan E. Martin, M.D., Department of Surgery, University of Connecticut School of Medicine, Connecticut Children's Medical Center, 282 Washington Street, Hartford, Connecticut 06106. email:
PannarajPS, , HultenKG, , GonzalezBE, , MasonEOJr, & KaplanSL: Infective pyomyositis and myositis in children in the era of community-acquired, methicillin-resistant Staphylococcus aureus infection. Clin Infect Dis43:953–960, 2006
PannarajPS, HultenKG, GonzalezBE, MasonEOJr, KaplanSL: Infective pyomyositis and myositis in children in the era of community-acquired, methicillin-resistant Staphylococcus aureus infection. Clin Infect Dis43:953–960, 2006)| false