J Med Cases

Journal of Medical Cases, ISSN 1923-4155 print, 1923-4163 online, Open Access

Article copyright, the authors; Journal compilation copyright, J Med Cases and Elmer Press Inc

Journal website https://www.journalmc.org

Case Report

Volume 13, Number 8, August 2022, pages 391-395

Unusual Case of Non-HIV Patient With Multifocal Pyomyositis: Developed on Appropriate Antibiotic Therapy

Figures

Figure 1. CT scan of the abdomen and pelvis with IV contrast: (a) On admission, no abscess was found; (b) At 10th day of admission, right psoas abscess (arrow) was observed. CT: computed tomography; IV: intravenous.

Figure 2. CT scan of chest with IV contrast revealed the abscess on the left pectoral major muscle (arrow). CT: computed tomography; IV: intravenous.

Figure 3. T2-weighted fat suppression image of lumbar spine MRI showed marrow edema involving L1 and L2 vertebral bodies suggesting osteomyelitis (arrows). Clinically, there were no signs of cord compression. MRI: magnetic resonance imaging.

Table

**Table 1.** Clinical Laboratory Results
Measure	Initial laboratory results on admission	Reference range
White blood cell count (per µL)	22,900	4,000 - 11,000
Red blood cell count (per µL)	5,210,000	4,500,000 - 5,900,000
Absolute neutrophil count (per µL)	20,840	1,800 - 7,500
Platelet count (per µL)	188,000	150,000 - 400,000
Hemoglobin (g/dL)	12.9	13.5 - 17.5
Sodium (mmol/L)	141	135 - 145
Potassium (mmol/L)	4.1	3.5 - 5.4
Chloride (mmol/L)	98	98 - 109
Carbon dioxide (mmol/L)	17	23 - 34
Anion gap (mmol/L)	26	4 - 14
Glucose (mg/dL)	519	70 - 200
Blood urea nitrogen (mg/dL)	27	8 - 20
Creatinine (mg/dL)	1.39	0.7 - 1.5
Albumin (dm/dL)	3.9	3.5 - 5.0
Total bilirubin (mg/dL)	0.7	0.0 - 1.5
Alanine aminotransferase (IU/L)	62	0 - 45
Aspartate aminotransferase (IU/L)	44	0 - 45
Total creatine kinase (IU/L)	2,645	0 - 195
Vancomycin trough goal (µg/mL)	19.4	15 - 20