Streptococcus anginosus (Streptococcus milleri Group) Pyomyositis in a 50-Year-Old Man with Acquired Immunodeficiency Syndrome: Case Report and Review of Literature
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We describe the first reported case of bacterial pyomyositisof the right thigh caused by Streptococcus anginosus(S. milleri group) in an HIV-infected patient. The clinicalpresentation was complicated by multiple ring-enhancinglesions detected on magnetic resonance imaging of thebrain. Evaluation for central nervous system toxoplasmosis,syphilis, and cryptococcal infection was negative. Aggressiveantibiotic therapy directed against S. anginosus and surgicaldebridement were limb salvaging. Clinicians should considerS. anginosus as a causative pathogen in HIV-associatedpyomyositis, particularly in complex presentations. Promptsurgical drainage may minimize complications due to S.anginosus, a pathogen associated with significant sequelaedue to its invasive nature.
KeywordsClindamycin Toxoplasmosis Brain Abscess Pyrimethamine Vastus Lateralis Muscle
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