1/14. streptococcus pyogenes pyomyositis.Group A beta-hemolytic Streptococcus pyomyositis continues to be an uncommon disease. We present a case of a 7-year-old boy with an M protein type 1, streptococcal pyrogenic exotoxin A and B, streptococcus pyogenes pyomyositis and streptococcal toxic shock syndrome.- - - - - - - - - - ranking = 1keywords = toxic shock syndrome, shock syndrome, toxic shock, shock (Clic here for more details about this article) |
2/14. Toxic shock syndrome and streptococcal myositis: three case reports.Group A streptococcal (GAS) infection is the most common cause of bacterial pharyngitis and has an important role in the pathogenesis of post-infective phenomena including rheumatic fever and glomerulonephritis. mortality from GAS is uncommon, particularly in the paediatric population. Toxic shock syndrome reflects the most severe form of GAS-related disease and is often associated with fasciitis or myositis. CONCLUSION: We present three cases of toxic shock syndrome secondary to (GAS) myositis demonstrating the importance of early recognition and provision of intensive care management.- - - - - - - - - - ranking = 2.283592888398keywords = toxic shock syndrome, shock syndrome, toxic shock, shock (Clic here for more details about this article) |
3/14. Pathophysiology and treatment of streptococcal toxic shock syndrome.We have recently encountered three cases of streptococcal toxic shock syndrome, each of which had a different cause. All the patients had inflammation of soft tissue in the lower extremities, and developed shock and multiple organ failure immediately after the clinical visit. The inflammation of soft tissue was necrotising fasciitis in one case, myositis in one case, and phlegmon in one. In the first case the debridement was incomplete, which resulted in an extensive ulceration. Wary of repeating this experience, we made an early diagnosis and did a thorough debridement in the second case. The patient was ultimately discharged without complications. It is rare that a patient with extensive myositis survives without amputation of the extremity. The third patient responded well to early treatment with antibiotics.- - - - - - - - - - ranking = 5.023836840096keywords = toxic shock syndrome, shock syndrome, toxic shock, shock (Clic here for more details about this article) |
4/14. Necrotizing soft tissue infection from decubitus ulcer after spinal cord injury.STUDY DESIGN: A case of necrotizing soft tissue infection in a patient with spinal cord injury with extension of infection into the spinal canal and spinal cord is presented. OBJECTIVE: To review the history, risk factors, pathophysiology, diagnosis, treatment, and morbidity and mortality regarding necrotizing soft tissue infection as they relate to spinal cord injury. SUMMARY OF BACKGROUND DATA: Necrotizing soft tissue infection related to decubitus ulcers is rare. To our knowledge, this is the first report of this disease related to a sacral decubitus ulcer with extension of the necrotizing infection into the spinal canal. methods: The clinical, radiographic, and pathologic features associated with necrotizing soft tissue infection are presented. The patient presented with a late-stage necrotizing soft tissue infection requiring extensive de-bridement of necrotic tissue, which the patient underwent on admission. RESULTS: The patent died of refractory septic shock and multiple-organ failure after surgery. CONCLUSION: Necrotizing soft tissue infections from decubitus ulcers are rare and unpredictable, and ultimately have a progressively aggressive course. The case reported herein is the first report of necrotizing soft tissue infection from a decubitus ulcer in a patient with spinal cord injury with extension into the spinal canal and spinal cord.- - - - - - - - - - ranking = 0.023836840095982keywords = shock (Clic here for more details about this article) |
5/14. Streptococcal myositis. A report of two cases.Two patients are described with acute streptococcal myositis. One of them died after a brief duration of illness in multiple organ failure; the other survived extensive muscular damage complicated by diffuse intravascular coagulation, acute renal failure, adult respiratory distress syndrome, bronchopneumonia, pseudomonas septicaemia and probably streptococcal toxic shock syndrome. Both patients received nonsteroidal antiphlogistics, purportedly involved in the pathogenesis of this syndrome. Based on a mouse model, clindamycin would seem to be the antibiotic of choice.- - - - - - - - - - ranking = 1keywords = toxic shock syndrome, shock syndrome, toxic shock, shock (Clic here for more details about this article) |
6/14. polymyositis mediated by T lymphocytes that express the gamma/delta receptor.BACKGROUND. The invasion and destruction of nonnecrotic muscle fibers by CD8 cytotoxic T cells is considered a hallmark of polymyositis. In the cases of polymyositis reported so far, the autoinvasive CD8 T cells expressed the common form of T-cell receptor for the recognition of antigen, the so-called alpha/beta T-cell receptor. We describe a 69-year-old man with polymyositis mediated by CD4-, CD8- T cells expressing the recently discovered, uncommon gamma/delta T-cell receptor. methods. We used immunofluorescence or immunoperoxidase techniques to study frozen sections of muscle from our patient, who had mild weakness of cervical and proximal limb muscles, and from control patients with polymyositis, inclusion-body myositis, dermatomyositis, or granulomatous myopathy with monoclonal antibodies against T-cell-related antigens (CD2, CD3, CD4, CD8, and gamma/delta T-cell receptor), B cells (CD22), major histocompatibility complex (MHC) and MHC-related antigens (MHC Class I, CD1a, CD1b, and CD1c), and the 65-kd heat-shock protein. The membrane contacts between the autoinvasive cells and the sarcolemma were investigated by electron microscopy. RESULTS. In the patient described here, but not in 28 others with inflammatory myopathies, myriad gamma/delta T cells surrounded and invaded nonnecrotic muscle fibers. All muscle fibers were highly reactive for MHC Class I antigen and the 65-kd heat-shock protein. Treatment with prednisone improved the clinical and histologic findings. CONCLUSIONS. polymyositis can be mediated by gamma/delta T cells. This new form of polymyositis appears to be highly responsive to steroids.- - - - - - - - - - ranking = 0.047673680191963keywords = shock (Clic here for more details about this article) |
7/14. pyomyositis in an HIV-positive premature infant: case report and review of the literature.pyomyositis is a purulent infection of skeletal muscle caused predominantly by staphylococcus aureus. Although not often encountered in the continental united states, pyomyositis is frequently seen in tropical areas. pyomyositis is difficult to diagnose as it may mimic other diseases. Delay in diagnosis may lead to septicemia, shock, and death. Recently, two cases of patients with pyomyositis and acquired immune deficiency syndrome were reported. We report a case of pyomyositis in a 7-week-old premature infant who subsequently tested positive for anti-hiv antibodies. A brief review of the topic is included.- - - - - - - - - - ranking = 0.023836840095982keywords = shock (Clic here for more details about this article) |
8/14. fusarium infections in patients with hematologic malignancies.Two cases of fusarium infection in patients with refractory hematologic malignancies are reported. In one patient septicemia progressed to death in septic shock. miconazole showed some effect in clearing the lesions. There is some evidence that mycotoxins are related with fusarium infections since severe myositis occurred in our patient. The other patient had a T-cell lymphoma, undergoing allogeneic bone marrow transplantation. The course was also complicated by fusarium infection of the skin. This patient died of multiorgan failure. Recent literature on fusarium is reviewed.- - - - - - - - - - ranking = 0.023836840095982keywords = shock (Clic here for more details about this article) |
9/14. Fulminant streptococcal myositis.A previously healthy 70-year-old woman was hospitalized for acute pain and edema of her right leg. Deep vein thrombosis was suspected, and she was put on anticoagulant therapy. Ten hours later, she developed a massive swelling of the leg with a well-demarcated violaceous discoloration of the skin and hemorrhagic bullae. She was in deep shock with signs of disseminated intravascular coagulation and adult respiratory distress syndrome. Gram stain of an aspirate from the bullae revealed short chains of gram-positive cocci, and multiple blood cultures showed abundant growth of streptococcus pyogenes. Despite intensive treatment, the patient died within hours. autopsy findings showed extensive pyomyonecrosis of the leg muscles and changes secondary to septicemia. The misleading initial clinical picture and the rarity of this disease entity in temperate climates delayed the correct diagnosis and resulted in a fatal outcome.- - - - - - - - - - ranking = 0.023836840095982keywords = shock (Clic here for more details about this article) |
10/14. Peracute streptococcal pyomyositis: report of two cases and review of the literature.pyomyositis occurs infrequently in temperate climates. The fulminating peracute form caused by group A Streptococcus is exceedingly rare. We present two children with streptococcal pyomyositis. One child was admitted in septic shock and required intensive supportive care during the acute stage of his illness. Persistent swelling and tenderness of his left thigh presented a diagnostic problem, which was eventually resolved with the aid of computerized tomography. Despite appropriate antibiotic therapy from the onset of illness, surgical debridement of the affected muscle was necessary. The second child presented with pyomyositis of the left paravertebral muscles and signs of incipient shock but did well on antibiotic therapy alone.- - - - - - - - - - ranking = 0.047673680191963keywords = shock (Clic here for more details about this article) |
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