Mycobacterium avium Complex Presenting as Inferior Rectus Pyomyositis.
Leo M Hall, H Joon Kim, Robert C Kersten
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Case in brief
An immunocompetent patient developed progressive, insidious proptosis. Evaluation identified a “cold abscess” involving the inferior rectus, with pyomyositis caused by Mycobacterium avium complex. The lesion required surgical drainage and prolonged medical treatment. The report also emphasizes the need for follow-up involving ophthalmology and infectious disease specialists to assess eradication of the organism.
What made this case unusual
The infection presented as inferior rectus pyomyositis with a “cold abscess” in an immunocompetent patient, an atypical periocular presentation of Mycobacterium avium complex.
Diagnostic / clinical pearl
Consider nontuberculous mycobacterial infection in extraocular muscle pyomyositis, even in an immunocompetent patient presenting with progressive proptosis.
Why it matters
The authors highlight that surveillance by ophthalmology and infectious disease specialists is needed to ensure complete eradication of this fastidious organism.