Compartment Syndrome of the Lateral Leg Secondary to Pyomyositis : A Case Report

Abstract

Introduction: Pyomyositis is a rare condition in temperate climates with approximately 15 cases reported annually in the United States. Predisposing factors include immunodeficiency, trauma, intravenous drug use, and bacteremia. We report a case not yet seen in the literature due to in- volvement of the lateral leg compartment, no history of predisposing factors, and clinical presen- tation with elevated compartment pressures. Case Report: We present a case of a 45 year old male who presented with worsening lower left leg pain for one week. The area felt firm and was exquisitely tender to palpation. Initial laborato- ry studies showed normal white blood cell counts and a slightly elevated erythrocyte sedimenta- tion rate. Compartment pressures were elevated and imaging revealed evidence of pyomyositis in the lateral compartment. Fasciotomy was avoided with prompt broad-spectrum antibiotics. At follow-up, the patient’s symptoms were resolved and no further treatment was needed. Conclusion: While pyomyositis is rare in nontropical countries, patients presenting with elevat- ed compartment pressures and no history of trauma or surgery should warrant further investiga- tion of the etiology with pyomyositis being included in the differential diagnosis.