Streptococcal necrotizing myositis: A case report and clinical review

Justin J. Hourmozdi, Dean A. Hawley, Christiane M. Hadi, Bilal Tahir, Rawle A. Seupaul

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

Background Streptococcal necrotizing myositis, also known as gangrenous myositis, is a very rare and severe soft tissue infection that predominately involves skeletal muscle and, eventually, superficial fascia and surrounding tissues. The presentation is often nonspecific until the rapidly progressing clinical course becomes apparent. A high morbidity and mortality rate has been reported in the small number of cases since 1900. Despite several attempts to better define the different entities causing necrotizing myositis, no single definitive causal relationship has been defined. Objectives A review of the literature is presented here to help clinicians distinguish those with necrotizing myositis from those with nonnecrotizing myositis when the clinician is at all confronted with the suspicion for such an infection. Case Report The case presented is that of a 48-year-old woman who had streptococcal necrotizing myositis. She died roughly 72 h after admission. After the patient's death, the clinical team sought consent for autopsy. Hospital staff made contact with family, and information was obtained from the family that the onset of the patient's symptoms was allegedly temporally related to her acquisition of a new tattoo on the right back, where the tattoo process allegedly included injection of cremated ashes of a pet dog. Conclusion A high level of suspicion for necrotizing myositis must be maintained for a patient with unexplained severe muscle pain and soft tissue swelling accompanied by systemic inflammatory response syndrome.

Original languageEnglish
Pages (from-to)436-442
Number of pages7
JournalJournal of Emergency Medicine
Volume46
Issue number3
DOIs
StatePublished - Mar 2014

Fingerprint

Myositis
Systemic Inflammatory Response Syndrome
Soft Tissue Infections
Myalgia
Pets
Subcutaneous Tissue
Autopsy
Skeletal Muscle
Dogs
Morbidity
Injections
Mortality
Infection

Keywords

  • myositis
  • necrotizing
  • review
  • streptococcal infections
  • streptococcal necrotizing myositis
  • streptococcal toxic shock syndrome

ASJC Scopus subject areas

  • Emergency Medicine

Cite this

Hourmozdi, J. J., Hawley, D. A., Hadi, C. M., Tahir, B., & Seupaul, R. A. (2014). Streptococcal necrotizing myositis: A case report and clinical review. Journal of Emergency Medicine, 46(3), 436-442. https://doi.org/10.1016/j.jemermed.2013.08.048

Streptococcal necrotizing myositis : A case report and clinical review. / Hourmozdi, Justin J.; Hawley, Dean A.; Hadi, Christiane M.; Tahir, Bilal; Seupaul, Rawle A.

In: Journal of Emergency Medicine, Vol. 46, No. 3, 03.2014, p. 436-442.

Research output: Contribution to journalArticle

Hourmozdi, JJ, Hawley, DA, Hadi, CM, Tahir, B & Seupaul, RA 2014, 'Streptococcal necrotizing myositis: A case report and clinical review', Journal of Emergency Medicine, vol. 46, no. 3, pp. 436-442. https://doi.org/10.1016/j.jemermed.2013.08.048
Hourmozdi, Justin J. ; Hawley, Dean A. ; Hadi, Christiane M. ; Tahir, Bilal ; Seupaul, Rawle A. / Streptococcal necrotizing myositis : A case report and clinical review. In: Journal of Emergency Medicine. 2014 ; Vol. 46, No. 3. pp. 436-442.
@article{6b505e9d395f4e17ad27bfd820a38e70,
title = "Streptococcal necrotizing myositis: A case report and clinical review",
abstract = "Background Streptococcal necrotizing myositis, also known as gangrenous myositis, is a very rare and severe soft tissue infection that predominately involves skeletal muscle and, eventually, superficial fascia and surrounding tissues. The presentation is often nonspecific until the rapidly progressing clinical course becomes apparent. A high morbidity and mortality rate has been reported in the small number of cases since 1900. Despite several attempts to better define the different entities causing necrotizing myositis, no single definitive causal relationship has been defined. Objectives A review of the literature is presented here to help clinicians distinguish those with necrotizing myositis from those with nonnecrotizing myositis when the clinician is at all confronted with the suspicion for such an infection. Case Report The case presented is that of a 48-year-old woman who had streptococcal necrotizing myositis. She died roughly 72 h after admission. After the patient's death, the clinical team sought consent for autopsy. Hospital staff made contact with family, and information was obtained from the family that the onset of the patient's symptoms was allegedly temporally related to her acquisition of a new tattoo on the right back, where the tattoo process allegedly included injection of cremated ashes of a pet dog. Conclusion A high level of suspicion for necrotizing myositis must be maintained for a patient with unexplained severe muscle pain and soft tissue swelling accompanied by systemic inflammatory response syndrome.",
keywords = "myositis, necrotizing, review, streptococcal infections, streptococcal necrotizing myositis, streptococcal toxic shock syndrome",
author = "Hourmozdi, {Justin J.} and Hawley, {Dean A.} and Hadi, {Christiane M.} and Bilal Tahir and Seupaul, {Rawle A.}",
year = "2014",
month = "3",
doi = "10.1016/j.jemermed.2013.08.048",
language = "English",
volume = "46",
pages = "436--442",
journal = "Journal of Emergency Medicine",
issn = "0736-4679",
publisher = "Elsevier USA",
number = "3",

}

TY - JOUR

T1 - Streptococcal necrotizing myositis

T2 - A case report and clinical review

AU - Hourmozdi, Justin J.

AU - Hawley, Dean A.

AU - Hadi, Christiane M.

AU - Tahir, Bilal

AU - Seupaul, Rawle A.

PY - 2014/3

Y1 - 2014/3

N2 - Background Streptococcal necrotizing myositis, also known as gangrenous myositis, is a very rare and severe soft tissue infection that predominately involves skeletal muscle and, eventually, superficial fascia and surrounding tissues. The presentation is often nonspecific until the rapidly progressing clinical course becomes apparent. A high morbidity and mortality rate has been reported in the small number of cases since 1900. Despite several attempts to better define the different entities causing necrotizing myositis, no single definitive causal relationship has been defined. Objectives A review of the literature is presented here to help clinicians distinguish those with necrotizing myositis from those with nonnecrotizing myositis when the clinician is at all confronted with the suspicion for such an infection. Case Report The case presented is that of a 48-year-old woman who had streptococcal necrotizing myositis. She died roughly 72 h after admission. After the patient's death, the clinical team sought consent for autopsy. Hospital staff made contact with family, and information was obtained from the family that the onset of the patient's symptoms was allegedly temporally related to her acquisition of a new tattoo on the right back, where the tattoo process allegedly included injection of cremated ashes of a pet dog. Conclusion A high level of suspicion for necrotizing myositis must be maintained for a patient with unexplained severe muscle pain and soft tissue swelling accompanied by systemic inflammatory response syndrome.

AB - Background Streptococcal necrotizing myositis, also known as gangrenous myositis, is a very rare and severe soft tissue infection that predominately involves skeletal muscle and, eventually, superficial fascia and surrounding tissues. The presentation is often nonspecific until the rapidly progressing clinical course becomes apparent. A high morbidity and mortality rate has been reported in the small number of cases since 1900. Despite several attempts to better define the different entities causing necrotizing myositis, no single definitive causal relationship has been defined. Objectives A review of the literature is presented here to help clinicians distinguish those with necrotizing myositis from those with nonnecrotizing myositis when the clinician is at all confronted with the suspicion for such an infection. Case Report The case presented is that of a 48-year-old woman who had streptococcal necrotizing myositis. She died roughly 72 h after admission. After the patient's death, the clinical team sought consent for autopsy. Hospital staff made contact with family, and information was obtained from the family that the onset of the patient's symptoms was allegedly temporally related to her acquisition of a new tattoo on the right back, where the tattoo process allegedly included injection of cremated ashes of a pet dog. Conclusion A high level of suspicion for necrotizing myositis must be maintained for a patient with unexplained severe muscle pain and soft tissue swelling accompanied by systemic inflammatory response syndrome.

KW - myositis

KW - necrotizing

KW - review

KW - streptococcal infections

KW - streptococcal necrotizing myositis

KW - streptococcal toxic shock syndrome

UR - http://www.scopus.com/inward/record.url?scp=84896739194&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84896739194&partnerID=8YFLogxK

U2 - 10.1016/j.jemermed.2013.08.048

DO - 10.1016/j.jemermed.2013.08.048

M3 - Article

C2 - 24161226

AN - SCOPUS:84896739194

VL - 46

SP - 436

EP - 442

JO - Journal of Emergency Medicine

JF - Journal of Emergency Medicine

SN - 0736-4679

IS - 3

ER -