Factors associated with pyomyositis: A systematic review and meta‐analysis.

Objectives: Pyomyositis, an acute bacterial infection of skeletal muscle usually resulting in abscess formation, is well recognised in tropical regions where it can account for up to 4% of adult surgical admissions. It is increasingly being reported from high‐income temperate countries. Pyomyositis occurs across all ages and in both sexes. Mortality ranges from 1% to 23%. Many risk factors have been suggested. We aimed to identify factors associated with pyomyositis. Methods: We undertook a systematic review and meta‐analysis, using PubMed, EMBASE, Scopus and the Cochran Library and hand‐searching published papers. The random‐effects model meta‐analysis was used to calculate pooled estimated odd ratios with the corresponding 95% confidence interval. Results: All studies in the systematic review (n = 25) and the meta‐analysis (n = 12) were hospital‐based. Seven only included children. Relatively few studies have been published in the last decade, the majority of which are from high‐income temperate settings. Staphylococcus aureus was the main organism isolated. Males under the age of 20 predominated, and mortality of up to 20% was reported. Factors associated with pyomyositis were HIV infection (OR = 4.82; 95% CI: 1.67–13.92) and fulfilling an AIDS surveillance definition (OR = 6.08; 95% CI: 2.79–13.23). Conclusions: Our meta‐analysis indicated significant associations between pyomyositis infection and HIV/AIDS. Major gaps in our understanding of the epidemiology, pathogenesis, clinical presentation, and outcome remain, highlighting the need for further research and more systematic studies. Pyomyositis merits consideration as a neglected tropical disease. [ABSTRACT FROM AUTHOR]