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Fulminant streptococcal myositis.

A Schattner1, E Hay, B Lifschitz-Mercer

  • 1Department of Medicine C, Kaplan Hospital, Rehovot, Israel.

Annals of Emergency Medicine
|March 1, 1989
PubMed
Summary
This summary is machine-generated.

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A severe Streptococcus pyogenes infection led to rapid pyomyonecrosis and septicemia in a 70-year-old woman. Despite initial deep vein thrombosis treatment, the aggressive bacterial infection caused fatal shock and adult respiratory distress syndrome.

Area of Science:

  • Infectious Diseases
  • Pathology
  • Critical Care Medicine

Background:

  • Deep vein thrombosis (DVT) is a common vascular condition.
  • Prompt diagnosis and treatment of DVT are crucial to prevent complications.

Observation:

  • A 70-year-old woman presented with acute leg pain and edema, initially suspected as DVT.
  • Rapid progression to massive swelling, violaceous skin discoloration, and hemorrhagic bullae occurred within hours.
  • The patient developed shock, disseminated intravascular coagulation (DIC), and adult respiratory distress syndrome (ARDS).

Findings:

  • Gram stain revealed Gram-positive cocci, and blood cultures identified Streptococcus pyogenes.
  • Autopsy confirmed extensive pyomyonecrosis (muscle infection) and septicemia.

Related Experiment Videos

  • The initial presentation mimicked DVT, delaying the diagnosis of the aggressive bacterial infection.

    • Implications:

    • Streptococcus pyogenes can cause rapidly fatal infections, including pyomyonecrosis and septic shock.
    • Early recognition of atypical presentations is vital for aggressive management of severe bacterial infections.
    • This case highlights the importance of considering rare but severe etiologies in patients with rapidly deteriorating conditions.