{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,6]],"date-time":"2026-01-06T05:57:18Z","timestamp":1767679038818,"version":"3.48.0"},"reference-count":14,"publisher":"BMJ","issue":"1","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2025,12,12]]},"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:p>\n                    Pyomyositis is a rare bacterial infection of skeletal muscle characterised by abscess formation, having significant morbidity. Early diagnosis is often challenging, especially in patients with atypical presentations. We report a case of pyomyositis in an immunocompetent adult male, promptly diagnosed using point-of-care ultrasound (POCUS) in the emergency department. The patient presented with fever, hypotension and confusion, and no source of infection was initially identified. Careful re-examination revealed subtle thigh asymmetry and tenderness. POCUS revealed an intramuscular collection in the left thigh and a diagnosis of pyomyositis was confirmed by ultrasound-guided aspiration and culture. Culture of the purulent fluid grew\n                    <jats:italic>Escherichia coli<\/jats:italic>\n                    , an unusual pathogen in pyomyositis, particularly in immunocompetent individuals. Rapid diagnosis enabled timely drainage and culture-directed antibiotic therapy, leading to complete recovery. This case underscores the importance of repeated clinical assessment and highlights the role of bedside ultrasound in rapidly identifying occult sources of sepsis, particularly when advanced imaging is delayed.\n                  <\/jats:p>","DOI":"10.1136\/bcr-2025-268793","type":"journal-article","created":{"date-parts":[[2026,1,6]],"date-time":"2026-01-06T05:50:13Z","timestamp":1767678613000},"page":"e268793","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Rapid bedside diagnosis of occult pyomyositis using point-of-care ultrasound in a patient with sepsis of unknown origin"],"prefix":"10.1136","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-8214-3356","authenticated-orcid":false,"given":"Srishti","family":"Gulati","sequence":"first","affiliation":[{"name":"Emergency Medicine, AIIMS New Delhi, New Delhi, DL, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8866-1046","authenticated-orcid":false,"given":"Rahul","family":"Chouhan","sequence":"additional","affiliation":[{"name":"Emergency Medicine, AIIMS New Delhi, New Delhi, DL, India"},{"name":"Trauma & Emergency, AIIMS Jodhpur, Jodhpur, RJ, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sanjeev","family":"Bhoi","sequence":"additional","affiliation":[{"name":"Emergency Medicine, AIIMS New Delhi, New Delhi, DL, India"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2026,1,5]]},"reference":[{"key":"2026010521500665000_19.1.e268793.1","doi-asserted-by":"crossref","first-page":"1210","DOI":"10.1111\/tmi.13669","article-title":"Factors associated with pyomyositis: A systematic review and meta\u2010analysis","volume":"26","author":"Ngor","year":"2021","journal-title":"Tropical Med Int Health"},{"key":"2026010521500665000_19.1.e268793.2","doi-asserted-by":"crossref","DOI":"10.1093\/ofid\/ofab098","article-title":"Pyomyositis and Infectious Myositis: A Comprehensive, Single-Center Retrospective Study","volume":"8","author":"Radcliffe","year":"2021","journal-title":"Open Forum Infect Dis"},{"doi-asserted-by":"publisher","key":"2026010521500665000_19.1.e268793.3","DOI":"10.1016\/j.amjmed.2004.03.031"},{"doi-asserted-by":"publisher","key":"2026010521500665000_19.1.e268793.4","DOI":"10.1136\/pgmj.2003.009274"},{"doi-asserted-by":"publisher","key":"2026010521500665000_19.1.e268793.5","DOI":"10.1016\/j.jemermed.2014.02.002"},{"key":"2026010521500665000_19.1.e268793.6","doi-asserted-by":"crossref","first-page":"482","DOI":"10.1016\/j.ajem.2014.08.064","article-title":"Point-of-care ultrasound differentiates pyomyositis from cellulitis","volume":"33","author":"Sauler","year":"2015","journal-title":"Am J Emerg Med"},{"doi-asserted-by":"publisher","key":"2026010521500665000_19.1.e268793.7","DOI":"10.1099\/jmm.0.46271-0"},{"key":"2026010521500665000_19.1.e268793.8","doi-asserted-by":"crossref","first-page":"102041","DOI":"10.1016\/j.berh.2025.102041","article-title":"Tropical pyomyositis","volume":"39","author":"Tirlangi","year":"2025","journal-title":"Best Pract Res Clin Rheumatol"},{"key":"2026010521500665000_19.1.e268793.9","doi-asserted-by":"crossref","DOI":"10.1002\/emp2.12394","article-title":"Emergency physician-performed bedside ultrasound of pyomyositis","volume":"2","author":"Al-Marzoog","year":"2021","journal-title":"J Am Coll Emerg Physicians Open"},{"doi-asserted-by":"publisher","key":"2026010521500665000_19.1.e268793.10","DOI":"10.1055\/s-0031-1293495"},{"key":"2026010521500665000_19.1.e268793.11","doi-asserted-by":"crossref","DOI":"10.3390\/microorganisms10122329","article-title":"Imaging of Musculoskeletal Soft-Tissue Infections in Clinical Practice: A Comprehensive Updated Review","volume":"10","author":"Spinnato","year":"2022","journal-title":"Microorganisms"},{"key":"2026010521500665000_19.1.e268793.12","doi-asserted-by":"crossref","first-page":"8","DOI":"10.4103\/aam.aam_62_18","article-title":"Doppler ultrasonographic evaluation of lower limbs deep-vein thrombosis in a teaching hospital, Northwestern Nigeria","volume":"19","author":"Ibrahim","year":"2020","journal-title":"Ann Afr Med"},{"key":"2026010521500665000_19.1.e268793.13","first-page":"8028","article-title":"Practical review of necrotizing fasciitis: Principles and evidence-based management. Plastic and Reconstructive Surgery - Global Open","volume":"14","author":"Guliyeva","year":"2024","journal-title":"Quant Imaging Med Surg"},{"key":"2026010521500665000_19.1.e268793.14","doi-asserted-by":"crossref","first-page":"8028","DOI":"10.21037\/qims-24-176","article-title":"Ultrasound guided procedures in the musculoskeletal system: A narrative review with illustrative examples","volume":"14","author":"Ruiz Santiago","year":"2024","journal-title":"Quant Imaging Med Surg"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2025-268793","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,6]],"date-time":"2026-01-06T05:50:15Z","timestamp":1767678615000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2025-268793"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1]]},"references-count":14,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,1,5]]},"published-print":{"date-parts":[[2026,1]]}},"alternative-id":["10.1136\/bcr-2025-268793"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2025-268793","relation":{},"ISSN":["1757-790X"],"issn-type":[{"type":"electronic","value":"1757-790X"}],"subject":[],"published":{"date-parts":[[2026,1]]}}}