Pyomyositis in north - eastern Nigeria: a 10-year review

Background : Pyomyositis is a suppurative disease of skeletal Muscle and a well-known disease with frequent occurrence in the tropics and subtropics, which continues to cause significant morbidity. Despite several studies of the disease in various regions of the tropics, there has been none from the northeast region of Nigeria, consisting of a largely rural population where the climate is hot and dry with little annual rainfall. Methods : A retrospective study of all patients seen and treated for pyomyositis in the University of Maiduguri Teaching Hospital from April 1990 to April 2000 was undertaken. Results : Fifty four patients with pyomyositis were seen and managed comprising 36 Males and 18 Females (M: F ratio 2:1). Two peak age incidences of 6-10 years and 31-40 years were noted. Most were from a labouring population and presented with a fully evolved disease affecting the large and powerful muscles of the thigh and calf in 59.7% of cases, the glutei in 12.9% and the trunk in 9.7%. The smaller muscles of the arm and forearm and head and neck were rarely affected. 8 patients had multiple lesions. Staphylococcus aureus was cultured in 91.8% of cases sensitive to cloxacillin, augmentin, chloramphenicol and erythromycin in that order. Conclusion : Prompt diagnosis, appropriate supportive therapy, effective antibiotic therapy and early drainage of abscesses have resulted in minimal mortality despite late presentation although hospital stay was prolonged.