Streptococcal pyomyositis in asplenia and underlying connective tissue disease.

Pyomyositis is an infection of skeletal muscles, commonly affecting deep longitudinal muscles of the lower extremities. Primary pyomyositis is uncommon in the United States. is the most common cause of pyomyositis, but is the most common cause of life-threatening bacterial infection in asplenic patients. Most cases of pyomyositis occur in immunocompromised patients. We describe a 31-year-old man with pyomyositis whose diagnosis and hospital course were complicated by an immunocompromised state from asplenia and an underlying connective tissue disease, Stickler syndrome. Underlying connective tissue diseases such as systemic lupus erythematosus and polymyositis can predispose patients to infection, but susceptibility with Stickler syndrome is less known. While pyomyositis is only seen in up to 0.2% of US hospital admissions, it remains a pertinent differential for patients with asplenia and connective tissue disease.