Postpartum iliopsoas pyomyositis due to community-acquired methicillin-resistant Staphylococcus aureus

BACKGROUND: Community-acquired, methicillin-resistant Staphylococcus aureus (MRSA) infections are on the rise among patients without risk factors for resistant microorganisms. A new, serious community-acquired MRSA manifestation, postpartum iliopsoas pyomyositis is described. CASE: A 24-year-old Hispanic female presented with back pain 9 days after a normal vaginal delivery. Magnetic resonance imaging showed extensive ill-defined edema of the left iliopsoas. Blood cultures yielded community-acquired MRSA. The patient received intravenous vancomycin for 6 days, followed by intravenous, then oral, trimethoprim-sulfamethoxazole. She was discharged on day 8 and made a full recovery. CONCLUSION: Iliopsoas pyomyositis is a new manifestation of community-acquired MRSA in the obstetric population that may masquerade as benign musculoskeletal back pain. Obstetricians must be alert to the range of presentations of this emerging pathogen.