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Staphylococcal pyomyositis in HIV-infected patients presents in an indolent fashion,which may delay appropriate diagnosis and treatment.Since staphylococcal pyomyositis is infrequently reported in the United States, the development of 14 such cases(five in this series and nine previously reported)among the first 140,000 cases of acquired immunodeficiency syndrome in this country implies that this patient population is predisposed to this infectious complication.The pathogenesis of this entity is uncertain,but it is notable that HIV-infected patients are commonly colonized by Staphylococcus aureus and that neutrophils from HIV- infected patients frequently manifest phagocytic,chemotatic,and oxidative defects,diminished expression of Fc RIII(CD16)and CR1,and impaired bactericidal activity against S.aureus. |
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