Bacterial, Fungal, Parasitic, and Viral Myositis

Abstract

SUMMARY Infectious myositis may be caused by a broad range of bacterial, fungal, parasitic, and viral agents. Infectious myositis is overall uncommon given the relative resistance of the musculature to infection. For example, inciting events, including trauma, surgery, or the presence of foreign bodies or devitalized tissue, are often present in cases of bacterial myositis. Bacterial causes are categorized by clinical presentation, anatomic location, and causative organisms into the categories of pyomyositis, psoas abscess, Staphylococcus aureus myositis, group A streptococcal necrotizing myositis, group B streptococcal myositis, clostridial gas gangrene, and nonclostridial myositis. Fungal myositis is rare and usually occurs among immunocompromised hosts. Parasitic myositis is most commonly a result of trichinosis or cystericercosis, but other protozoa or helminths may be involved. A parasitic cause of myositis is suggested by the travel history and presence of eosinophilia. Viruses may cause diffuse muscle involvement with clinical manifestations, such as benign acute myositis (most commonly due to influenza virus), pleurodynia (coxsackievirus B), acute rhabdomyolysis, or an immune-mediated polymyositis. The diagnosis of myositis is suggested by the clinical picture and radiologic imaging, and the etiologic agent is confirmed by microbiologic or serologic testing. Therapy is based on the clinical presentation and the underlying pathogen.

Rhabdomyolysis a result of azithromycin and statins: an unrecognized interaction

“…Well-established interacting agents such as gemfibrozil, clarithromycin and erythromycin were co-reported in 16 cases [2,[4][5][6][7]9]. Various infectious agents may also cause rhabdomyolysis [31], consequently the underlying infection for which azithromycin was given could have led to rhabdomyolysis without any drug effect. Moreover, other risk factors such as decreased renal function and patient obesity were listed on some of the reports and therefore may have contributed to the disease onset.…”

More parasitic myositis cases in humans in Australia, and the definition of genetic markers for the causative agents as a basis for molecular diagnosis

“…Parasitic myositis is mainly reported to be associated with protists, flatworms or roundworms (nematodes), the latter of which often involves Toxocara and Trichinella species (Crum-Cianflone, 2008). However, some unusual myositis cases involving nematodes have been reported in the literature.…”

“…There are many aetiologies of myositis, including injury, medicines, toxins, excessive exercise/exertion, chronic diseases (involving the immune or endocrine system), electrolyte imbalance and infections. Infectious myositis can involve one or more species of viruses, bacteria, fungi and/or parasites (Crum-Cianflone, 2008, 2010. For parasitic myositis, clinical diagnosis is often assisted by the use of complementary laboratory tests that detect and attempt to microscopically identify the agent in histological sections of muscle biopsies from patients.…”

Piomiosite em atletas após o uso de esteroides anabolizantes: relato de casos

“…Bacterial forms are the commonest cause and, among these, S. aureus is the agent most commonly encountered, as seen in the cases reported here (5)(6)(7)(8) . Most infections are diagnosed clinically, and imaging examinations only complement the diagnosis.…”