Reporting a case of 25 year male, labourer, who presented in ER with complaints of acute onset shortness of breath with orthopnoea, right sided chest pain. On admission patient had tachycardia, hypotension with erythema and tenderness present over right side of chest. The events followed after pulling a 60 kg load manually. B/l lower limb doppler was s/o DVT. Right upper limb Doppler was suggestive of thrombus in right IJV and Subclavian vein. Mri right shoulder revealed multiple abscess in muscles of right shoulder and back. The abscess was drained by the surgical team and culture and sensitivity grew staphylococcus aureus thereby confirming the diagnosis of tropical pyomyositis with pagetschroetter syndrome.

Tropical pyomyositis is a disease of tropical countries, which is characterised by suppuration within skeletal muscles, presenting as single or multiple abscesses. The diagnosis is confirmed either by aspiration of pus from the affected muscles or biopsy. Upper extremity deep vein thrombosis (UEDVT) is seen in approximately 5 to 10 percent of all cases of DVT, classically occurring in the dominant arm of young athletes. The purpose of the case report is to make physicians more familiar with this potentially life threatening but curable infective disease entity.

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Dr Ashiti Jain

Junior Resident, Internal Medicine, MGM Medical College and Hospital, Navi Mumbai, Maharashtra, India