Science and Education Publishing American Journal of Medical Case Reports 2374-216X 4 9 2016 10 27 Bifocal Pyomyositis: An Uncommon Complication in Diabetic Patient 319 320 EN Ines Kechaou Internal Medicine Department, University hospital of Charles Nicolle, Tunis, Tunisia Eya Cherif Imene Boukhris Samira Azzabi Lamia Ben Hassine Narjes Khalfallah AJMCR2016497 10.12691/ajmcr-4-9-7 2016 6 16 2016 8 18 2016 10 25 Pyomyositis is a severe infectious complication reported in diabetic patients. A double noncontiguous location of this complication is exceptional. We report a case of a 58-year-old woman, who presented with a painful swelling left thigh and arm. The diagnosis of bifocal pyomyositis in the left vastusintermedius quadriceps and in the triceps muscle of the left arm was made on MRI findings. The causative agent was not isolated because of preceding antibiotic use. In this observation diabetes mellitus constitute the aim predisposing factor revealing pyomyositis by ketoacidosis.