Microbiology and management of myositis.

This review summarizes the microbiology, management, and prevention of myositis. Muscular infections frequently occur in areas of the body that have been compromised or injured by a foreign body, trauma, ischemia, injection of illicit drug, malignancy, or surgery. These infections can develop very rapidly to life-threatening systemic illness. The predominant pathogens are Staphylococcus aureus, Group A streptococci (GAS), gram-negative aerobic and facultative bacilli, and the indigenous aerobic and anaerobic cutaneous and mucous membranes local microflora. Pyogenic myositis can be classified into either GAS necrotizing myositis, clostridial myonecrosis (gas gangrene), or nonclostridial (crepitant) myositis. Intensive surgical and medical therapy that includes the administration of intravenous fluids and antimicrobial therapy is an essential element in management of muscle infection.