[Streptococcal toxic shock-like syndrome with necrotizing myositis].
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.
Rhomberg
M
M
Universitätsklinik für Plastische und Wiederherstellungschirugie Innsbruck. martin.rhomberg@uibk.ac.at
Furtmüller
F
F
Haidinger
D
D
Nopp
W H
WH
Rieder-Scharinger
J
J
Schobersberger
W
W
Piza-Katzer
H
H
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