Bilateral obturator pyomyositis with visceral involvement in an immunocompetent adult patient treated without surgery.

Background: Primary pyomyositis is a rare bacterial infection that affects large muscle groups mainly in immunocompromised patients. Treatment options include antibiotic treatment with surgical or radiologic interventions.
Case: A 22-year-old immunocompetent athlete was diagnosed with bilateral obturator muscle pyomyositis involving pelvic floor muscles and the urinary bladder after muscle injury during training. Intravenous antibiotic treatment was administered, resulting in eradication of the infection.
Conclusion: This is the first case of bilateral obturator pyomyositis with coexisting involvement of pelvic floor muscles (levator ani) and viscera (urinary bladder) treated exclusively and with success by the administration of appropriate antibiotic therapy. A non-operative approach may could be attempted for the avoidance of postoperative morbidity and complications, especially when early clinical suspicion and diagnostic work-up lead to early diagnosis.