Sphingomonas paucimobilis associated with localised calf myositis

We studied a 29-year-old man with no relevant medical history who was admitted to our hospital for increasing pain localised to the calves and toe walking, caused by an inability to put weight on the heels, over the preceding 10 days. Thirteen days prior to admission the patient complained of sore throat and enlarged tender laterocervical lymph nodes for which he had been prescribed cefuroxime (250 mg twice a day). In the next few days the sore throat gradually improved and 10 days before admission he presented with low grade fever and pain in the calves. The pain in the calves, greater in the left calf, worsened progressively and, 8 days before admission, because of increasing pain when putting weight on the heels, he went to the emergency room of a peripheral hospital. A bacterial syndrome was suspected, cefuroxime was discontinued and levofloxacin (250 mg twice a day) was prescribed without any clinical benefit. Because of the increasing pain in the calves, persistence of low grade fever and inability to walk because of the pain, the patient was admitted to our institution.