Pyomyositis is a bacterial infection of the skeletal muscles which results in an abscess. Pyomyositis is most common in tropical areas but can also occur in temperate zones. Diagnosis
Diagnosis is done via the following manner:
Pus discharge culture and sensitivity
X ray of the part to rule out osteomyelitis
Creatinine phosphokinase (more than 50,000 units)
MRI is useful
Ultrasound guided aspiration

Treatment
The abscesses within the muscle must be drained surgically (not all patient require surgery if there is no abscess). Antibiotics are given for a minimum of three weeks to clear the infection. Epidemiology
Pyomyositis is most often caused by the bacterium Staphylococcus aureus. The infection can affect any skeletal muscle, but most often infects the large muscle groups such as the quadriceps or gluteal muscles.Pyomyositis is mainly a disease of children and was first described by Scriba in 1885. Most patients are aged 2 to 5 years, but infection may occur in any age group. Infection often follows minor trauma and is more common in the tropics, where it accounts for 4% of all hospital admissions. In temperate countries such as the US, pyomyositis was a rare condition (accounting for 1 in 3000 pediatric admissions), but has become more common since the appearance of the USA300 strain of MRSA.Gonococcal pyomyositis is a rare infection caused by Neisseria gonorrhoeae. Additional images
References

Maravelas R, Melgar TA, Vos D, Lima N, Sadarangani S (2020). "Pyomyositis in the United States 2002-2014". J Infect. 80(5):497-503. doi:10.1016/j.jinf.2020.02.005. PMID 32147332. == External links ==
Ezetimibe/atorvastatin (trade names Liptruzet, Atozet) is a cholesterol lowering combination drug. In the United States, it was approved in May 2013, by the Food and Drug Administration for the treatment of elevated low-density lipoprotein (LDL) in patients with primary or mixed hyperlipidemia as adjunctive therapy to diet. It has also been approved to reduce elevated total cholesterol and elevated LDL in patients diagnosed with homozygous familial hypercholesterolemia as an adjunctive treatment to other hyperlipidemia treatments.Some cardiologists opposed the approval, because the combination reduced LDL cholesterol in a clinical trial, but it did not reduce heart disease. A clinical trial studying the endpoints of heart attacks, strokes and heart-related deaths is scheduled to conclude in 2014.Liptruzet was withdrawn from sale by its manufacturer in June 2015, but not for reasons of safety or effectiveness. Mechanism of action
This combination drug works to reduce cholesterol levels through two different pathways. The ezetimibe component of the medication works by inhibiting cholesterol absorption from food while the atorvastatin component inhibits intrinsic cholesterol production in the liver. Safety
The drug is not safe to use in patients with active liver disease or unexplained persistent elevations in hepatic transaminase. Women that are pregnant or may become pregnant should not use the drug. It is a teratogenic agent that may disrupt the growth and development of a fetus. Immediate discontinuation is recommended in patients that become pregnant while taking this drug. Adverse effects
Commonly reported adverse effects include:
Musculoskeletal pain
Elevated liver enzymes (AST and ALT)
Gastrointestinal problems such as abdominal pain and nausea

See also
Ezetimibe
Ezetimibe/simvastatin


== References ==