Leg pain following Staphylococcus aureus bacteraemia.

To cite: Mehmood M, Bradford AD, Khasawneh FA. BMJ Case Rep Published online: [please include Day Month Year] doi:10.1136/bcr-2014204603 DESCRIPTION Presentation A 47-year-old Indian immigrant with a medical history significant for diabetes presented with severe sepsis due to complicated methicillin susceptible Staphylococcus aureus (MSSA) bacteraemia. His transoesophageal echocardiogram was negative. His condition improved markedly on intravenous nafcillin and his follow-up blood cultures were negative. In spite of the above, he continued to complain of throbbing pain in different muscle groups in his lower limbs (LL). Physical examination showed tender and swollen thighs and left calf. Overlying skin was normal. CT of the LL in the second week of illness was negative but a follow-up CT scan with intravenous contrast in the third week of illness showed multiple pockets of pus in the LL muscle groups (figure 1) consistent with pyomyositis. He underwent CT-guided drainage, which grew MSSA. Subsequently, he completed 4 weeks of intravenous antibiotic therapy with complete resolution.