Tropical primary pyomyositis in children of the UK: an emerging medical challenge

Pyomyositis is a commonly encountered condition in the tropics. It was not described in the UK until 1998. The reason for the increasing incidence is not understood. We sought to identify the experience gained of this condition within a UK paediatric tertiary referral unit. Retrospective review of cases of pyomyositis from our institution since 1998 was undertaken to identify demographics, presentation, diagnosis and management. Thirteen cases were identified. The obturator internus was most commonly affected (62%). Staphylococcus aureus was cultured in nine cases (69%). One diagnostic retroperitoneal exploration was performed and all cases were identified by computed tomography or magnetic resonance imaging. To our knowledge, this is the first UK series of pyomyositis, reflecting its increasing Western incidence. Early diagnosis and treatment with antibiotics is all that is needed in the majority of cases. A greater awareness of this emerging condition is necessary to prevent misdiagnosis and unnecessary surgical intervention by all surgeons.