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Pyomyositis is the primary infection of skeletal muscles, accompanied by abscess formation in the suppurative phase but may be without a focal fluid collection in the presuppurative phase. We describe three patients, one with insulin-dependent diabetes mellitus, another with sickle cell disease, and the third a previously healthy child with varicella infection who developed pyomyositis. Ultrasound or magnetic resonance imaging suggested the diagnosis in each case. The patients were treated with intravenous antibiotic therapy and two required abscess drainage. The infection in the third resolved without surgical drainage. None of our patients had residual functional limitations. We believe that a high index of suspicion and prompt diagnosis can prevent complications from pyomyositis.

Mumps should be included in the differential diagnosis of a comatose patient, particularly when mumps is prevalent in the community. Mumps encephalitis sometimes occurs with normal CSF cell count and protein content. Some exanthems associated with mumps may represent dual infections. That mumps virus alone may produce a rash is suggested by a report cited and by one patient in this series.