Pyomyositis of the Biceps Brachii in a Young Adult Male

Pyomyositis is a skeletal muscle infection mainly found in tropical regions. It commonly affects larger muscles, especially those of the hips. MRI tends to be the gold standard for diagnosis. Staphylococcus aureus remains the predominant causal organism in most cases of pyomyositis. Immunocompromised patients are more likely to be susceptible to this infection. In our case, an immunocompetent 27-year-old male in rural southwest Virginia was found to have a large abscess in his upper arm. Contrast-enhanced CT scan was acquired prior to drainage, leading to the diagnosis of pyomyositis. Empiric treatment with IV vancomycin 1 g q 24 hours and piperacillin/tazobactam 3.375 mg q 8 hours, prompt incision and drainage, and negative pressure wound VAC led to a complete resolution of the infection.