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Case Report

Diagnosis and management of acute pyomyositis associated with bacterial endocarditis: case report

By
Christian Alexander Lema Guaraca ,
Christian Alexander Lema Guaraca

Clínica de Especialidades España. Cuenca, Ecuador

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Victoria Guadalupe Macas Valarezo ,
Victoria Guadalupe Macas Valarezo

Ministerio de Salud Pública, Centro de Salud Cumbaratza. Zamora, Ecuador

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Vicente Javier Guerrero Arcentalez ,
Vicente Javier Guerrero Arcentalez

Ministerio de Salud Pública, Centro de Salud Palmas. Cuenca, Ecuador

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Jacqueline Briggithe Criollo Mendieta ,
Jacqueline Briggithe Criollo Mendieta

Ministerio de Salud Pública, Centro de Salud Fumisa. Buena Fé, Ecuador

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Oscar Esteban Maldonado Espinoza ,
Oscar Esteban Maldonado Espinoza

Médico General en libre ejercicio profesional, Red Complementaria de Salud. Cuenca, Ecuador

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Diego Germán Cajamarca Velesaca ,
Diego Germán Cajamarca Velesaca

Ministerio de Salud Pública, Centro de Salud El Airo. Loja, Ecuador

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Estuardo Javier Carrión Abad ,
Estuardo Javier Carrión Abad

Ministerio de Salud Pública, Centro de Salud Chilla. Chilla, Ecuador

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Jose Freddy Villa Pallashco ,
Jose Freddy Villa Pallashco

Médico General en libre ejercicio profesional, Red Complementaria de Salud. Cuenca, Ecuador

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Abstract

Background: Pyomyositis associated with bacterial endocarditis constitute clinical entities with significant repercussions on the patient's health status. They represent infectious emergencies whose microorganism involved is Staphylococcus Aureus in more than half of the cases.
Case Report: A 59-year-old male patient, with a history of type 2 diabetes mellitus, was admitted due to a clinical picture compatible with cellulitis and deep vein thrombosis in the left lower limb. Magnetic resonance imaging was performed, evidencing the presence of a collection (abscess) at the level of the gastrocnemius muscle and bacteremia due to methicillin-sensitive Staphylococcus Aureus. An echocardiogram was performed with the presence of vegetations on the aortic heart valve.
Evolution: During the hospital stay, the patient remained hemodynamically stable with torpid evolution of the lesion in the left leg due to microorganism resistance to the antibiotics initially established (cefazolin and clindamycin). Targeted antibiotic treatment is performed based on the results of the blood culture and abscess culture based on oxacillin, which shows significant improvement in the lesion and the patient's health status. A new control echocardiogram was performed with a decrease in the diameter of the vegetation on the heart valve. Medical discharge was decided after the results of the control blood culture with a report of absence of bacterial growth, with continuation of antibiotic therapy for 4 more weeks.
Conclusions: Pyomyositis and bacterial endocarditis are pathologies that require multidisciplinary management due to their high risk of morbidity and mortality. Individualizing each case can be decisive in safeguarding the patient's life and ensuring an adequate full recovery of his health.

How to Cite

1.
Lema Guaraca CA, Macas Valarezo VG, Guerrero Arcentalez VJ, Criollo Mendieta JB, Maldonado Espinoza OE, Cajamarca Velesaca DG, Carrión Abad EJ, Villa Pallashco JF. Diagnosis and management of acute pyomyositis associated with bacterial endocarditis: case report. Salud, Ciencia y Tecnología [Internet]. 2023 Jul. 11 [cited 2024 May 24];3:436. Available from: https://revista.saludcyt.ar/ojs/index.php/sct/article/view/436

The article is distributed under the Creative Commons Attribution 4.0 License. Unless otherwise stated, associated published material is distributed under the same licence.

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