Guideline sources The following summarized guidelines for the evaluation and management of pyomyositis are prepared by our editorial team based on guidelines from the Infectious Diseases Society of America (IDSA 2014). 1 Guidelines 1. Diagnostic investigations Diagnostic imaging: Obtain MRI as the recommended imaging modality for establishing the diagnosis of pyomyositis. B Consider CT scan or ultrasound studies as additional helpful tests in the evaluation of suspected pyomyositis. B Blood and abscess culture: obtain blood cultures as well as cultures of abscess material. B 2. Medical management Antibiotic therapy: administer vancomycin as initial empirical therapy. B Show 3 more https://web.pathway.md/diseases/recHifK0HEKDe4Jli 1/2 6/29/23, 11:37 PM Pyomyositis Pathway 3. Therapeutic procedures Abscess drainage: perform early drainage of purulent material. A 4. Follow-up and surveillance Management of persistent bacteremia: obtain repeat imaging studies in patients with persistent bacteremia to identify undrained foci of infection. B Clinical findings Symptoms Past medical history Fever Bacterial infection Muscle pains Diabetes mellitus Hiv-1 infection Integument exam Immunocompromising condition Recurrent abscess Subcutaneous nodules References 1. Stevens DL, Bisno AL, Chambers HF et al. Practice guidelines for the diagnosis and management of skin and soft tissue infections: 2014 update by the Infectious Diseases Society of America. Clin Infect Dis. 2014 Jul 15;59 2):e10 52. Open 2. L Christin, G A Sarosi. Pyomyositis in North America: case reports and review. Clin Infect Dis. 1992 Oct;15 4 668 77. Open https://web.pathway.md/diseases/recHifK0HEKDe4Jli 2/2