Iliopsoas pyomyositis as the initial presentation of HIV infection : A case report

Pyomyositis is a bacterial infection of skeletal muscle increasingly reported outside tropical regions, particularly in immunocompromised patients. We report the case of a 45-year-old woman who presented with acute right-sided abdominal pain and fever. Contrast-enhanced computed tomography showed inflammatory involvement of the right iliopsoas muscle without abscess formation. Blood cultures identified Staphylococcus aureus, and further investigations revealed previously undiagnosed human immunodeficiency virus infection. The patient was successfully treated with antibiotic therapy, with favorable clinical outcome. This case emphasizes the diagnostic role of computed tomography and the need to search for underlying immunodeficiency in patients presenting with pyomyositis.