Pyomyositis and fasciitis by carbapenem resistant microorganism in a patient with severe tophaceus gout

Abstract Pyomyositis, defined as a suppurative muscle infection, is a rare entity that is classified as tropical or non-tropical according to the geographical region. The case of a patient with a history of severe tophaceous gouty arthritis, coming from tropical wet climate in Colombia, who presented with suggestive cellulitis, with a torpid evolution despite standard dual management. An associated abscess was documented, and initially abscessed cellulitis and septic arthritis were suspected, the latter was finally ruled out, once the muscle origin of the abscess becames evident by means of computed tomography and ultrasonography. Intraoperatively, an abscess with fascia involvement and intramuscular tophaceous disease was observed. Surgical drainage and repeated washes were required. Carbapenem resistant Klebsiella pneumoniae was isolated, requiring last-line antibiotic therapy for a prolonged period of time.