Tropical pyomyositis, a thiamine-deficiency disease.

On the basis of clinical observations made in Shanghai which confirmed the clinical and experimental findings of Osawa in Japan, it is suggested that thiamine deficiency is an essential contributary factor in producing tropical pyomyositis (TPM). It was found that the majority of patients affected by TPM suffer or have previously suffered from beriberi. The practical disappearance of TPM in Japan in recent years supports the above view. Thiamine deficiency induces a biochemical lesion (Peters) in the pyruvate oxidase system of the muscle, which breaks down its normal resistance to infection and opens the gate to bacterial agents. It is possible that in different parts of the world other or additional factors may play a similar role to that of thiamine deficiency. It is suggested that a wide survey should be undertaken--perhaps by the World Health Organisation--especially in areas in which TPM is endemic, using all relevant methods, to elucidate the factor or factors responsible for the development of TPM.