Diagnostic and Therapeutic Challenges in Multifocal MRSA Pyomyositis: A Case Report.

Pyomyositis is a rare bacterial infection of skeletal muscle, historically associated with tropical climates but increasingly observed in temperate areas, particularly among immunocompromised individuals. Its nonspecific early symptoms often overlap with other soft-tissue infections, causing diagnostic delay. We report the case of a 64-year-old lumberjack with poorly controlled diabetes and a remote history of lymphoma, who developed multifocal MRSA pyomyositis with septic pulmonary emboli following orthopedic trauma and surgery. The condition rapidly evolved into septic shock requiring ICU admission, targeted antibiotic therapy, and multiple image-guided drainages. The patient progressively recovered and was discharged to rehabilitation on Postoperative Day 45. Pyomyositis should be considered in immunocompromised patients presenting with localized pain, systemic symptoms, and recent trauma. Early imaging, microbiological confirmation, and multidisciplinary management are critical for improving outcomes.