What’s Viral Myositis?

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Viral myositis is a rare condition where viral infections cause skeletal muscles to become inflamed, weak, and painful. It can affect different muscle groups and may lead to life-threatening complications. Treatment involves antiviral medications, fluids, steroids, and bed rest. Diagnosis is done through physical exams, blood tests, and imaging tests. HIV is the most common cause of myositis.

Viral myositis is a rare complication of a viral infection that causes skeletal muscles to become inflamed, weak, and painful. A person may have very isolated pain in a single muscle group, such as the muscles around the hip or shoulder, or the condition may cause discomfort in many different places on the body at once. Symptoms tend to develop rapidly and an individual may find themselves unable to get out of bed in the later stages of viral myositis. Treatment typically consists of a course of antiviral medications, fluids to prevent dehydration, steroids to reduce inflammation, and extended bed rest.

Infection and muscle inflammation are not common with most viral infections. Most cases of myositis are related to autoimmune conditions in which the immune system mistakenly attacks healthy nerve and muscle fibers, acting as if they were dangerous pathogens. In the case of viral myositis, however, the immune system’s attack is not misleading; viral pathogens really pose a threat to the body. Human immunodeficiency virus (HIV) is the most common cause of myositis. Acute infections with coxsackieviruses, influenza and many other pathogens can also lead to muscle inflammation.

A person who develops myositis is likely to experience pain, weakness, and swelling in one or more muscles. The leg quadriceps and lower back muscles are the most common sites. Inflammation can also affect the shoulders, arms and neck. Myositis can be accompanied by more general symptoms of fever, fatigue, and body aches. In severe cases, the lungs, kidneys or heart may also be affected, leading to life-threatening complications.

A doctor can diagnose viral myositis with a physical exam and blood tests. The doctor asks about the patient’s history and symptoms and examines different muscles to locate sites of tenderness. Imaging tests such as ultrasounds and X-rays help confirm swelling and inflammation in the muscles. Blood samples are screened for the presence of HIV or another virus that may be causing the symptoms.

Treatment for myositis largely depends on the type of virus involved and the severity of the symptoms. Patients with minor pain and low fever are prescribed antiviral medications and asked to get plenty of rest until symptoms resolve. If a person has significant discomfort, they may be hospitalized so that antivirals, fluids, and corticosteroids can be given intravenously. HIV-positive individuals typically require more aggressive initial treatment and lifelong ongoing medical therapy for their conditions. Most cases of viral myositis can be resolved or at least improved with careful treatment.




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