Diabetic pyomyositis: an uncommon cause of a painful leg.

P yomyositis is a pyogenic infection of the skeletal muscle that can lead to abscess formation (1,2). It commonly occurs in the tropics, but is also recognized in temperate climates, with HIV infection and diabetes being the main predisposing factors (3,4). The diagnosis of pyomyositis is difficult due to its vague clinical presentation and poor localizing signs. Early in its course, the differential diagnosis includes musculoskeletal aches, osteomyelitis, septic arthritis, muscle hematoma, muscle rupture, thrombophlebitis, or deep venous thrombosis. A delay in diagnosis may result in compartment syndrome, sepsis, and death. The long-term sequelae of pyomyositis include osteomyelitis of adjacent bones, muscle scarring, prolonged hospitalization, and significant functional impairment (5). We report a patient with diabetes who presented with a painful leg and was diagnosed with pyomyositis.