PYOMYOSITIS IN SICKLE-CELL DISEASE - AN UNEXPECTED DIAGNOSIS

Pyomyositis is a pyogenic infection of muscle, leading to abscess formation. Pyomyositis is frequent in tropical areas but uncommon in areas with a temperate climate [4]; therefore, diagnosis can be difficult and can be delayed [6].Sickle cell disease (SCD) can be complicated by vascular occlusion that can cause painful crises, avascular bone necrosis, priapism, leg ulcers, and proliferative retinopathy. The underlying mechanism is not completely understood. In particular, hemoglobin SC SCD is associated with the finding of isolated necrosis of the femoral head [3]. Furthermore, patients with SCD have an increased risk of infection [1]. Valeriano-Marcet and Kerr associated SC crises with myonecrosis and myofibrosis [5]. To our knowledge, no association of SCD with pyomyositis has been reported. We describe a patient with sickle cell disease (Hb SC) in whom recurrent multiple, non tropical, non-HIV-associated pyomyositis appeared a diagnostic problem.