title: Necrotizing streptococcal myositis of an extremity: a rare case report.
abstract: Necrotizing myositis is a severe and very rare streptococcal soft tissue infection involving the superficial fascia and muscle. Its clinical symptoms are nonspecific until the appearance of a fulminant clinical course with soft tissue destruction and septic shock. A high mortality and morbidity rate has been reported in the few cases over the last century. Despite several attempts to better define the different entities causing this necrotizing soft tissue infection, no clear treatment has been outlined. We present the case of a 47-year-old woman who had an acute necrotizing myositis after a stab wound. The diagnosis of necrotizing myositis was only established after surgical treatment with a pathology report. We reviewed the literature to highlight the clinical difficulty of a preoperative diagnosis and surgical treatment.
authors.affiliation: Panorama Orthopedics and Spine Center, Orthopedic Trauma Service Saint Anthony Hospital Central, Denver, CO, USA. ehase2011@uky.edu
authors.forename: Erik A
authors.initials: EA
authors.lastname: Hasenboehler
authors.forename: Patrick J
authors.initials: PJ
authors.lastname: McNair
authors.forename: Edmund B
authors.initials: EB
authors.lastname: Rowland
authors.forename: Jon M
authors.initials: JM
authors.lastname: Burch
mesh_terms: D000671:Amputation, Surgical; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D003646:Debridement; D004550:Elbow / Q000601:surgery; D019115:Fasciitis, Necrotizing / Q000382:microbiology / Q000473:pathology* / Q000628:therapy; D005260:Female; D006801:Humans; D007275:Injections, Intravenous; D008875:Middle Aged; D009220:Myositis / Q000382:microbiology / Q000473:pathology* / Q000628:therapy; D013290:Streptococcal Infections / Q000150:complications / Q000473:pathology* / Q000628:therapy; D016896:Treatment Outcome; D014951:Wounds, Stab / Q000382:microbiology / Q000473:pathology* / Q000628:therapy; D000092464:Elbow Injuries
chemical_list: D000900:Anti-Bacterial Agents