title: [Streptococcal toxic shock-like syndrome with necrotizing myositis].
abstract: Streptococcal toxic shocklike syndrome is caused by group A streptococci and characterized by multiorgan failure and soft-tissue necrosis, often in young patients with a bland history and at most a minor trauma. Diagnosis is reached through the clinical presentation, imaging methods and positive bacterial verification. The course is fulminant and in the case of muscle involvement, mortality reaches 80-100%. Therapy consists of immediate fasciotomy and often of debridement of affected soft tissues with high-dose antibiotics in intensive care. Sometimes an unconfirmed diagnosis must be sufficient to operate. We report the case of a 29-year-old man without an exceptional history who was forced to undergo thigh amputation, multiple soft-tissue debridements, and after a total of 240 erythrocyte concentrates, finally hip joint enucleation.
authors.affiliation: Universitätsklinik für Plastische und Wiederherstellungschirugie Innsbruck. martin.rhomberg@uibk.ac.at
authors.forename: M
authors.initials: M
authors.lastname: Rhomberg
authors.forename: F
authors.initials: F
authors.lastname: Furtmüller
authors.forename: D
authors.initials: D
authors.lastname: Haidinger
authors.forename: W H
authors.initials: WH
authors.lastname: Nopp
authors.forename: J
authors.initials: J
authors.lastname: Rieder-Scharinger
authors.forename: W
authors.initials: W
authors.lastname: Schobersberger
authors.forename: H
authors.initials: H
authors.lastname: Piza-Katzer
mesh_terms: D000328:Adult; D000671:Amputation, Surgical; D003937:Diagnosis, Differential; D006621:Hip Joint / Q000601:surgery; D006801:Humans; D008297:Male; D009220:Myositis / Q000209:etiology* / Q000601:surgery*; D012772:Shock, Septic / Q000175:diagnosis*; D013290:Streptococcal Infections / Q000175:diagnosis*; D013297:Streptococcus pyogenes; D013848:Thigh / Q000601:surgery