Necrotising Myositis, the Deadly Impersonator
We report two cases of patients with necrotising myositis who presented initially with limb pain and swelling on a background of respiratory complaints. Patient 1, a previously well 38-year-old female, underwent various investigations in the emergency department for excessive lower limb pain and a s...
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| Format: | Article |
| Language: | English |
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Wiley
2014-01-01
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| Series: | Case Reports in Surgery |
| Online Access: | http://dx.doi.org/10.1155/2014/485651 |
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| author | A. Rahman A. K. Abou-Foul A. Yusaf J. Holton L. Cogswell |
| author_facet | A. Rahman A. K. Abou-Foul A. Yusaf J. Holton L. Cogswell |
| author_sort | A. Rahman |
| collection | DOAJ |
| description | We report two cases of patients with necrotising myositis who presented initially with limb pain and swelling on a background of respiratory complaints. Patient 1, a previously well 38-year-old female, underwent various investigations in the emergency department for excessive lower limb pain and a skin rash. Patient 2, a 61-year-old female with a background of rheumatoid arthritis and hypertension, presented to accident and emergency feeling generally unwell and was treated for presumed respiratory sepsis. Both deteriorated rapidly and were referred to the plastic surgery team with soft tissue necrosis, impending multiorgan failure and toxaemia. Large areas of necrotic muscle and skin were debrided, which grew group A streptococci, Streptococcus pyogenes. Patient 1 had a high above knee amputation of the left leg with extensive debridement of the right. Despite aggressive surgical intervention and microbiological input with intensive care support, patient 2 died. These two cases highlight the importance of early diagnosis and prompt surgical and pharmacological intervention in managing this life-threatening disease. Pain is the primary symptom with skin changes being a late and subtle sign in a septic patient. The Laboratory Risk Indicator for Necrotising Fasciitis (LRINEC) may be of use if there is concern to aid diagnosis of this life-threatening disease. |
| format | Article |
| id | doaj-art-26292695fda54a649ba0f20f50182c3d |
| institution | Kabale University |
| issn | 2090-6900 2090-6919 |
| language | English |
| publishDate | 2014-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Surgery |
| spelling | doaj-art-26292695fda54a649ba0f20f50182c3d2025-02-03T06:00:33ZengWileyCase Reports in Surgery2090-69002090-69192014-01-01201410.1155/2014/485651485651Necrotising Myositis, the Deadly ImpersonatorA. Rahman0A. K. Abou-Foul1A. Yusaf2J. Holton3L. Cogswell4Department of Plastic and Reconstructive Surgery, Oxford University Hospitals, John Radcliffe Hospital, Headley Way, Oxford OX3 9DU, UKDepartment of Plastic and Reconstructive Surgery, Oxford University Hospitals, John Radcliffe Hospital, Headley Way, Oxford OX3 9DU, UKDepartment of Plastic and Reconstructive Surgery, Oxford University Hospitals, John Radcliffe Hospital, Headley Way, Oxford OX3 9DU, UKDepartment of Plastic and Reconstructive Surgery, Oxford University Hospitals, John Radcliffe Hospital, Headley Way, Oxford OX3 9DU, UKDepartment of Plastic and Reconstructive Surgery, Oxford University Hospitals, John Radcliffe Hospital, Headley Way, Oxford OX3 9DU, UKWe report two cases of patients with necrotising myositis who presented initially with limb pain and swelling on a background of respiratory complaints. Patient 1, a previously well 38-year-old female, underwent various investigations in the emergency department for excessive lower limb pain and a skin rash. Patient 2, a 61-year-old female with a background of rheumatoid arthritis and hypertension, presented to accident and emergency feeling generally unwell and was treated for presumed respiratory sepsis. Both deteriorated rapidly and were referred to the plastic surgery team with soft tissue necrosis, impending multiorgan failure and toxaemia. Large areas of necrotic muscle and skin were debrided, which grew group A streptococci, Streptococcus pyogenes. Patient 1 had a high above knee amputation of the left leg with extensive debridement of the right. Despite aggressive surgical intervention and microbiological input with intensive care support, patient 2 died. These two cases highlight the importance of early diagnosis and prompt surgical and pharmacological intervention in managing this life-threatening disease. Pain is the primary symptom with skin changes being a late and subtle sign in a septic patient. The Laboratory Risk Indicator for Necrotising Fasciitis (LRINEC) may be of use if there is concern to aid diagnosis of this life-threatening disease.http://dx.doi.org/10.1155/2014/485651 |
| spellingShingle | A. Rahman A. K. Abou-Foul A. Yusaf J. Holton L. Cogswell Necrotising Myositis, the Deadly Impersonator Case Reports in Surgery |
| title | Necrotising Myositis, the Deadly Impersonator |
| title_full | Necrotising Myositis, the Deadly Impersonator |
| title_fullStr | Necrotising Myositis, the Deadly Impersonator |
| title_full_unstemmed | Necrotising Myositis, the Deadly Impersonator |
| title_short | Necrotising Myositis, the Deadly Impersonator |
| title_sort | necrotising myositis the deadly impersonator |
| url | http://dx.doi.org/10.1155/2014/485651 |
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