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Streptococcal Necrotizing Myositis: The Role of Magnetic Resonance Imaging : A Case Report

Streptococcal Necrotizing Myositis: The Role of Magnetic Resonance Imaging : A Case Report <h2>Introduction</h2> Streptococcal necrotizing myositis is a rare but severe infection of skeletal muscle that is caused almost exclusively by Streptococcus pyogenes (Group-A streptococcus). The literature on this condition is sparse. In 1930, Abrami and Worms 1 reported on two patients who died of this infection. Since then, fewer than thirty cases have been reported, to our knowledge 2 - 9 . Streptococcal necrotizing myositis has a much more sinister prognosis than do other bacterial infections of skeletal muscle, such as pyomyositis. The condition is difficult to diagnose; hence, treatment is often delayed, contributing to its associated high mortality rate. We report a case of a five-year-old girl who survived streptococcal necrotizing myositis. A high index of suspicion combined with emergent magnetic resonance imaging facilitated early diagnosis and radical débridement of the necrotic muscles. The clinical and magnetic resonance imaging features of streptococcal necrotizing myositis are compared with those of pyomyositis. <h2>Case Report</h2> A five-year-old nondiabetic girl presented with a twenty-four-hour history of severe pain in the left hip and thigh following a single day of fever that had resolved spontaneously one week prior to admission. There was no recent history of injury or injection in the region of http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Journal of Bone and Joint Surgery Wolters Kluwer Health

Streptococcal Necrotizing Myositis: The Role of Magnetic Resonance Imaging : A Case Report

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Publisher
Wolters Kluwer Health
Copyright
Copyright © 2001 by The Journal of Bone and Joint Surgery, Inc.
ISSN
0021-9355
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Abstract

<h2>Introduction</h2> Streptococcal necrotizing myositis is a rare but severe infection of skeletal muscle that is caused almost exclusively by Streptococcus pyogenes (Group-A streptococcus). The literature on this condition is sparse. In 1930, Abrami and Worms 1 reported on two patients who died of this infection. Since then, fewer than thirty cases have been reported, to our knowledge 2 - 9 . Streptococcal necrotizing myositis has a much more sinister prognosis than do other bacterial infections of skeletal muscle, such as pyomyositis. The condition is difficult to diagnose; hence, treatment is often delayed, contributing to its associated high mortality rate. We report a case of a five-year-old girl who survived streptococcal necrotizing myositis. A high index of suspicion combined with emergent magnetic resonance imaging facilitated early diagnosis and radical débridement of the necrotic muscles. The clinical and magnetic resonance imaging features of streptococcal necrotizing myositis are compared with those of pyomyositis. <h2>Case Report</h2> A five-year-old nondiabetic girl presented with a twenty-four-hour history of severe pain in the left hip and thigh following a single day of fever that had resolved spontaneously one week prior to admission. There was no recent history of injury or injection in the region of

Journal

Journal of Bone and Joint Surgery – Wolters Kluwer Health

Published: Nov 1, 2001

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