article = {SCR-2019-3-114}
title = {Primary Infective Pyomyositis of the Hip Abductors Presenting as Trochanteric Bursitis}
journal = {Surgical Case Reports}
year = {2019}
issn = {2613-5965}
doi = {http://dx.doi.org/10.31487/j.SCR.2019.03.14}
url = {https://www.sciencerepository.org/primary-infective-pyomyositis-of-the-hip-abductors-presenting-as-trochanteric-bursitis_SCR-2019-3-114 
author = {Curtin  PD,Gerard A. Sheridan,Heffernan  EJ,Johnson  DP,}
keywords = {Pyomyositis, trochanteric bursitis, diabetes mellitus, staphylococcus aureus}
abstract ={Introduction: Pyomyositis is an uncommon suppurative infection of skeletal muscle. In recent times, it is
becoming more prevalent in the context of immunosuppression and diabetes and it is known to show a
preponderance for pelvic girdle muscles. We present a case of a primary infective pyomyositis of the gluteal
musculature in a diabetic patient which presented initially as a typical greater trochanteric bursitis.
Case Report: A 52 year old female presented with sudden onset left lateral thigh pain localized to the
greater trochanteric region. Relevant comorbidities included a BMI of 35, uncontrolled non insulindependent diabetes mellitus and hypertension. Her HbA1c on presentation was 97mmol/mol. She had a
raised CRP of 92 with a normal white cell count. MRI confirmed an ill-defined collection overlying the
gluteal tendon insertions with extensive surrounding oedema. The patient was surgically managed and
underwent incision and drainage through a direct lateral incision. Samples sent were positive for
staphylococcus aureus and the patient was commenced on IV flucloxacillin. They progressed to a full
recovery.
Conclusion: We recommend that consideration be given to infective pyomyositis in the differential for
patients presenting acutely with trochanteric hip pain. Pyrexia, raised inflammatory markers and a history
of diabetes mellitus or other immunosuppressive conditions should raise clinical suspicion for occult
infection even in the setting of a common clinical complaint such as trochanteric hip pain. MRI is essential
in achieving early diagnosis and surgical drainage and medical management can lead to a good clinical
recovery.}