Piomiositis y absceso epidural por SAMR en 2 pacientes inmunocompetentes

Introduction

Central nervous system (CNS) and musculoskeletal infections can be severe, especially in immunocompromised individuals. Epidural abscess and pyomyositis are caused by Staphylococcus aureus (S. aureus), requiring early diagnosis and treatment to improve prognosis.

Case report

Two young patients without comorbidities developed severe infections caused by methicillin-resistant S. aureus. The first patient developed primary pyomyositis with sepsis and muscle collections, requiring drainage and intravenous antibiotics. The second patient presented with an epidural abscess causing spinal cord compression, requiring laminectomy and antibiotics. Both showed neurological improvement, although they had mild motor sequelae one month after discharge.

Discussion

S. aureus is responsible for invasive infections such as pyomyositis and epidural abscess. These infections pose diagnostic challenges since their symptoms are nonspecific. Laboratory tests are helpful but insufficient, making magnetic resonance imaging crucial for identification. Treatment involves a combination of antibiotics and either drainage or surgery in advanced cases. Prognosis depends on early diagnosis and the neurological status prior to treatment.

Conclusion

Pyomyositis and epidural abscess are serious and uncommon infections, with diagnosis often delayed due to nonspecific symptoms. Magnetic resonance imaging is essential for detection. Timely treatment with antibiotics and drainage improves prognosis, although pre-treatment neurological status influences recovery.