Staphylococcal pyomyositis in patients infected by the human immunodeficiency virus

Article Abstract:

Pyomyositis, the formation of abscesses in striated muscle, occurs most often in the tropics, and fewer than 50 cases have been reported in the US. The first report of pyomyositis in a patient infected with the human immunodeficiency virus (HIV) was described in 1987. In this case, pyomyositis developed in the absence of known risk factors, such as recent injury, residence in a tropical country, intravenous drug abuse, or diabetes mellitus. Bacteria could not be isolated from pus-containing material obtained from the patient's abscesses. However, the patient did respond to treatment with the antibiotics gentamicin and flucloxacillin. Ten addition cases of HIV-associated pyomyositis have been reported, and five are now described in this article. The symptoms of pyomyositis caused by staphylococcal bacteria in HIV-infected patients are reviewed. All patients developed a fever and pain without an increase in numbers of white blood cells. There was little evidence of inflammation, and the patients had no history of injury, muscle inflammation related to HIV infection or zidovudine treatment, or complications related to staphylococcal infections. Two patients had elevated levels of immunoglobulin E (an immune protein present in allergic disease) and increased numbers of eosinophils (a granular type of white blood cell). Staphylococcal pyomyositis is uncommon in the US, but HIV-infected patients appear to be at increased risk of this disease. The disease process of this infectious complication of HIV is not clear, but may be related to the frequent colonization of HIV-infected patients with Staphylococcus aureus and the impaired ability of their neutrophils (a type of white blood cell) to prevent or fight S. aureus infection. (Consumer Summary produced by Reliance Medical Information, Inc.)

Development and progression, Striated muscle, Staphylococcal infections

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Pyomyositis in patients with the human immunodeficiency virus: an unusual form of disseminated bacterial infection

Article Abstract:

Pyomyositis is a bacterial infection of the skeletal muscle that most often occurs in tropical climates. There have been 83 cases of pyomyositis reported in the US since 1971. The cases described are of six patients with human immunodeficiency virus (HIV) infection, which was complicated by pyomyositis. These cases were reported between November 1988 and June 1990. Large abscesses developed in several muscles and were treated with antibiotics and drainage of the abscesses. Other symptoms included fever, muscle pain, and inflammation of the skeletal muscle. In one case, pyomyositis was associated with the development of rhabdomyolysis, the deterioration of skeletal muscle. Most infections were caused by the bacteria Staphylococcus aureus. In addition, the first case of HIV infection-related pyomyositis caused by a gram-negative bacteria is reported. The bacterial infections often spread to other body sites, or recurred despite antibiotic treatment. Hence, HIV-infected patients with pyomyositis may require prolonged treatment. (Consumer Summary produced by Reliance Medical Information, Inc.)

Gram-negative bacteria, Muscles

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Response of HIV-associated disseminated cat scratch disease to treatment with doxycycline

Article Abstract:

Infection with human immunodeficiency virus (HIV) is often complicated by skin disorders, such as Kaposi's sarcoma. Recent reports have identified a microorganism in HIV-related skin and blood vessel lesions that resembles the bacillus-type organism that causes cat scratch disease. In cat scratch disease, the bacteria Pasteurella multocida are usually transmitted by the bite or scratch of a cat. The cat scratch bacillus or a similar organism was shown to cause the widespread development of node-like skin lesions in HIV-infected patients. This HIV-related skin disease has been referred to as epithelioid angiomatosis, bacillary angiomatosis, and disseminated cat scratch disease. Epithelioid or bacillary angiomatosis has been treated with a combination of antibiotics, although it remains unclear which antibiotic is most effective. A case is described of a 48-year-old homosexual man with acquired immunodeficiency syndrome (AIDS) and advanced cat scratch disease who responded to treatment with the antibiotic doxycycline. (Consumer Summary produced by Reliance Medical Information, Inc.)

Health aspects, Evaluation, Causes of, Drug therapy, Doxycycline, Cutaneous manifestations of general diseases, Skin manifestations, Lymphadenitis, Angiomatosis

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