Patients suffering from chronic renal failure (CRF) are at increased risk for contracting tuberculosis (TB) due to their impaired immunity. In this patient group, extrapulmonary involvement is more common than the pulmonary form of TB, and symptoms tend to be milder and less distinctive than those seen in the general population. Pyomyositis secondary to TB is relatively rare. We report a case of TB pyomyositis in the setting of CRF. The nonspecific symptoms that are typical of CRF patients with TB make it particularly difficult to establish the diagnosis in this patient group. In order to avoid diagnostic delays, which may increase the risk of complications and mortality, TB should be kept in mind in any case of ongoing fever and infection that does not respond to seemingly appropriate therapy. In addition, TB should always be suspected in endemic areas, even in the absence of osseous involvement.

1.
Andrew OT, Schoenfeld PY, Hopewell PC, Humphreys MH: Tuberculosis in patients with end-stage renal disease. Am J Med 1980;68:59–65.
2.
Garcia-Leoni ME, Martin-Scapa C, Rodeno P, Valderrabano F, Moreno S, Bouza E: High incidence of tuberculosis in renal patients. Eur J Clin Microbiol Infect Dis 1990;9:283–285.
3.
Chiedozi LC: Pyomyositis: Review of 205 cases in 112 patients. Am J Surg 1979;137:255–259.
4.
Gibson RK, Rosenthal SJ, Lukert BP: Pyomyositis: Increasing recognition in temperate climates. Am J Med 1984;77:768–772.
5.
Özdemir FN, Güz G, Kayataş M, Sezer S, Arslan H, Turan M: Tuberculosis remains an important factor in the morbidity and mortality of hemodialysis patients. Transplant Proc 1998;30:846–847.
6.
Puttick MP, Stein HB, Chan RM, Elwood RK, How AR, Reid GD: Soft tissue tuberculosis: A series of 11 cases. J Rheumatol 1995;22:7:1321–1325.
7.
Abdelwahab I, Kenan S, Hermann G, Klein MJ: Tuberculous gluteal abscess without bone involvement. Skeletal Radiol 1998;27:36–39.
8.
Mateos A, Monte R, Rodriguez A, Corredoira J: Primary psoas abscess caused by Mycobacterium tuberculosis. Scand J Infect Dis 1998;30:319.
9.
Abdelwahab IF, Kenan S: Tuberculous abscess of the brachialis and biceps brachii muscles without osseous involvement. A case report. Bone Joint Surg Am 1998;80:1521–1524.
10.
Johnson DW, Herzig KA: Isolated tuberculous pyomyositis in a renal transplant patient. Nephrol Dial Transplant 2000;15:543.
11.
Lupatkin H, Brau N, Flomenberg P, Simberkoff MS: Tuberculous abscesses in patients with AIDS: Clin Infect Dis 1992;14:1040–1044.
12.
Belzunegui J, Plazaola I, Uriarte E, Pego JM: Primary tuberculous muscle abscess in a patient with systemic lupus erythematosus. Br J Rheum 1995;341:1177–1178.
13.
Giglio A, Pinczowski H, Portugal G, Feher O: Tuberculous skeletal muscle involvement in acute leukemia: Report on two cases. Tumori 1997;83:618–620.
14.
Hirano T, Srinivasan G, Janakiraman N, Pleviak D, Mukhopadhyay D: Gallium 67 citrate scintigraphy in pyomyositis. J Pediatr 1980;97:596–598.
15.
Heycock JB, Noble TC: Four cases of syringe-transmitted tuberculosis. Tubercle 1961;42:25–27.
16.
Goldblatt M, Cremin BJ: Osteo-articular tuberculosis: Its presentation in coloured races. Clin Radiol 1978;29:669–677.
17.
Gupta S, Suri S, Gulati M, Singh P: Ilio-psoas abscesses: Percutaneous drainage under image guidance. Clin Radiol 1997;52:704–707.
18.
Kim JY, Park YH, Choi KH, Park SH, Lee HY: MRI of tuberculous pyomyositis. J Comput Assist Tomogr 1999;23:454–457.
19.
Parry RG, Playford EG, Looke DF, Falk M: Soft-tissue abscess as the initial manifestation of miliary tuberculosis in a renal transplant recipient with prolonged fever. Nephrol Dial Transplant 1998;13:1860–1863.
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.