title: [Necrotizing fasciitis, myositis, arthritis, and streptococcal toxic shock syndrome caused by group G Streptococcus. Report of one case].
abstract: BACKGROUND
  Necrotizing fasciitis (NF), myositis, and streptococcal toxic shock syndrome (STSS) associated with group G ß-hemolytic streptococcus (GGS) occasionally coincide.
  
  
  METHODS
  We describe a case of GGS simultaneously occurring with NF, myositis, arthritis, and STSS in an 83-year-old woman with sequelae of cerebrovascular disease, hospitalized after two days of fever and with a painful swollen left foot. She was hypotensive, her foot had purplish discoloration, which showed blisters spreading to the lower third of the leg, and no crepitus was present. Fluid, vasopressive support, tigecyclin, and clindamycin were used. Debrided tissue and fluid aspirated from the knee joint revealed Gram-positive cocci. The patient developed renal and respiratory failure on the fifth day, requiring support. She underwent amputation above the knee of the left leg, after which her condition improved. She was discharged one month later.
  
  
  CONCLUSIONS
  GGS can cause life-threatening infections such as NF, myositis, and/or STSS. GGS usually afflicts aging patients with comorbid states, and occasionally healthy subjects.
authors: Servicio de Medicina Interna y Cirugía, Hospital San José, Instituto Tecnológico y de Estudios Superiores de Monterrey, Monterrey, Nuevo León, México. svmonterrey@yahoo.com.
authors: Juan Jacobo
authors: JJ
authors: Ayala-Gaytán
authors: Ángel
authors: Á
authors: Martínez-Vela
authors: Homero
authors: H
authors: Náñez-Terreros
authors: Claudia Elena
authors: CE
authors: Guajardo-Lara
authors: Salvador Bruno
authors: SB
authors: Valdovinos-Chávez
mesh_terms: D000369:Aged, 80 and over; D001170:Arthritis, Infectious / Q000175:diagnosis* / Q000382:microbiology; D019115:Fasciitis, Necrotizing / Q000175:diagnosis* / Q000382:microbiology; D005260:Female; D006801:Humans; D009220:Myositis / Q000175:diagnosis* / Q000382:microbiology; D012772:Shock, Septic / Q000175:diagnosis* / Q000382:microbiology; D013290:Streptococcal Infections / Q000150:complications / Q000175:diagnosis*
keywords: Group G ß-hemolytic streptococcus; Necrotizing fasciitis; Streptococcal toxic shock syndrome