Taylorbrewer8416

Intramuscular abscesses, particularly in the biceps brachii, are an extremely rare phenomenon. When present they are usually secondary to trauma, intramuscular injections, or systemic disease.

A 56 year old diabetic woman presented to our emergency department with a 3 day history of fever, cough, and a painful left shoulder. Although she had a mechanical fall 2 weeks prior, she denied any pain in her shoulder immediately after the fall. She also denied any history of drug abuse or recent intramuscular injection. On examination she looked acutely unwell and was in acute septic shock requiring inotropic support. Computed tomography of her shoulder showed a large intramuscular abscess in her left biceps brachii muscle. She was immediately taken to the operating theatre for open exploration and washout of the abscess. The multiloculated abscess was tracking into the glenohumeral joint. Post operatively she showed significant clinical improvement and after a 2 week course of intravenous antibiotics recovered well and was discharged from hospital.

Intramuscular abscesses are usually seen in patients who are immunocompromised. Intramuscular needle injections and haematomas secondary to trauma are also risk factors. To the best of our knowledge, there have only been 4 published reports in the English literature of intramuscular abscess formation in the biceps brachii.

We report a case of a seemingly spontaneous intramuscular biceps abscess in a diabetic patient presenting with septic shock.

We report a case of a seemingly spontaneous intramuscular biceps abscess in a diabetic patient presenting with septic shock.In recent years, interest in the research of P2 receptor (P2R)-mediated responses has grown significantly due to the recognition of the involvement of these receptors in various physiological and pathological processes. Despite all the progress made in the functional characterization of P2Rs, purinergic signaling research is still limited by the lack of selective or efficient ligands for different receptor subtypes. In this sense, several molecules have been tested towards these receptors as agonists or antagonists. Historically, natural products have always been sources of new bioactive substances for diverse purposes. However, compared to synthetic molecules, the number of natural products assessed for P2R ligands is still low. 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