J Korean Soc Emerg Med.  2004 Oct;15(5):417-419.

A Case of Streptococcal Toxic Shock Syndrome with Myonecrosis due to Group A beta-hemolytic Streptococcus

• Je SM
• Jo YS
• Yoon YS
• Park IC
• Kim SH

Abstract

Streptococcal toxic shock syndrome with myonecrosis is a rapidly progressive process that kills 80% of patients in 72-96 h. Various bullae, hypotension, fever, and evidence of organ failure are late clinical manifestations. The symptoms and signs of myonecrosis can be nonspecific and misleading, not clearly revealing the involvement of deep skeletal muscle. Thus, the challenge to clinicians is to make an early diagnosis and to intervene with aggressive fluid replacement, emergent surgical debridement, and general supportive measures. We describe an presentation of myonecrosis of the lower extremities secondary to group A beta-hemolytic streptococcus infection in a 21-years-old woman. In addition, the patient had no history or evidence of trauma to the affected area.

Keyword

Streptococcal infection; Toxic shock syndrome; Neerotizing fasciitis

MeSH Terms

Debridement
Early Diagnosis
Female
Fever
Humans
Hypotension
Lower Extremity
Muscle, Skeletal
Shock, Septic*
Streptococcal Infections
Streptococcus*