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Pain in the Shoulder: Anaerobic Pyomyositis

Dylewski, Joseph MDCM*†‡; Brunner, Roger MDCM§; Reid, Miles MDCM

Infectious Diseases in Clinical Practice: March 2010 - Volume 18 - Issue 2 - p 113-114
doi: 10.1097/IPC.0b013e3181ab2ea8
Case Reports

Pain involving the shoulder is a common complaint encountered by physicians working in the emergency department. The differential diagnosis includes traumatic injuries such as fractures and dislocations, overuse injuries such as tendonitis and arthritis, and referred pain from a diaphragmatic focus such as pneumonia or myocardial infarct. Infection involving the soft tissues of the shoulder is rare and, most frequently, a result of direct trauma. Pyomyositis is an infection of the muscle from a transient bacteremia and is usually caused by Staphylococcus aureus. It is most likely to occur after a muscle injury. We describe a patient with pyomyositis of the shoulder caused by an anaerobic bacterial infection of the infraspinatus muscle, which occurred after a dental extraction.

From the Departments of *Medicine and †Laboratories, and ‡St. Mary's Hospital Center; Departments of §Emergency Medicine and ∥Radiology, St. Mary's Hospital Center, Montreal, Quebec, Canada.

Reprints: Joseph Dylewski, MDCM, St. Mary's Hospital Center, 3830 Lacombe Ave, Montreal, Quebec, Canada H3T 1M5. E-mail:

The authors have no funding or conflicts of interest to disclose.

© 2010 Lippincott Williams & Wilkins, Inc.