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J Korean Soc Emerg Med > Volume 15(5); 2004 > Article
Journal of The Korean Society of Emergency Medicine 2004;15(5): 417-419.
A Case of Streptococcal Toxic Shock Syndrome with Myonecrosis due to Group A beta-hemolytic Streptococcus
Sang Mo Je, Young Soon Jo, Yoo Sang Yoon, In Cheol Park, Seung Ho Kim
Department of Emergency Medicine, Yonsei University College of Medicine, Seoul, Korea. edksh@yumc.yonsei.ac.kr
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.
Key words: Streptococcal infection, Toxic shock syndrome, Neerotizing fasciitis
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