Tuberculous pyomyositis in a patient with diabetes mellitus

Abstract

Pyomyositis is a pyogenic infection of the skeletal muscle which can cause significant morbidity and mortality if not properly treated. Diabetes mellitus (DM) is a well recognized risk factor for development of pyomyositis. The usual causative pathogen of pyomyositis in diabetes mellitus is Staphylococcus aureus. Tuberculous pyomyositis as the sole manifestation of tuberculosis or as the causative agent of soft tissue infection in persons with diabetes mellitus is very rare and thus the diagnosis may be missed. A high index of suspicion is required for the diagnosis of this potentially treatable clinical entity so that appropriate treatment can be instituted promptly to avoid complications. This is a report of a 48 year old Nigerian woman, a known type 2 DM patient who presented with a painful ‘boil’ on the back. Ziehl Neelsen staining done on pus aspirate showed Acid Alcohol Fast Bacilli. She responded well to antituberculous therapy.