从咽喉到肢体:A群链球菌性咽炎后的室室综合征一例新病例。

IF 1 Q4 INFECTIOUS DISEASES
Case Reports in Infectious Diseases Pub Date : 2025-05-06 eCollection Date: 2025-01-01 DOI:10.1155/crdi/5016797
Simar Goyal, Justin Choy, Kendall Wermine, Sidart Pradeep, Khazeema Hafeez, Rusty Milhoan, Lavanya Srinivasan
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引用次数: 0

摘要

急性筋膜室综合征是由于封闭筋膜间隙内压力增加而引起的一种医学紧急情况,如果不治疗,可导致组织缺血和潜在的肢体丧失或死亡。虽然通常继发于创伤,但罕见病例与链球菌感染有关。然而,没有文献记载的病例室综合征起源于A群链球菌(GAS)咽炎。我们提出一个35岁的女性,糖尿病前期,谁提出了恶化的右下肢(RLE)疼痛和水肿后,发热性疾病与咽炎急诊科。入院时咽拭子和随后的血液培养均检测出溶血气体呈阳性。尽管最初治疗败血症和蜂窝织炎合并肌炎,但她出现了筋膜室综合征,需要紧急切开筋膜。她术后出现低血压、中毒性休克样综合征、月经过多和转氨炎,但最终通过静脉注射抗生素和逐步进行雅各梯手术缝合伤口恢复。该报告是已知的第一例由弥散性气体咽炎引起的非创伤性急性下肢筋膜室综合征,并可能指出美国新出现的气体毒株的新毒力因子的发展。该病例强调了认识到气体性咽炎作为严重全身性感染的潜在来源的重要性,因为早期发现和积极治疗侵袭性气体性感染可能有助于预防危及生命的并发症。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
From Throat to Limb: A Novel Case of Compartment Syndrome Following Group A Streptococcal Pharyngitis.

Acute compartment syndrome is a medical emergency caused by increased pressure within a closed fascial space, leading to tissue ischemia and potential limb loss or death if untreated. While typically secondary to trauma, rare cases have been associated with streptococcal infections. However, no documented case exists of compartment syndrome originating from Group A Streptococcus (GAS) pharyngitis. We present a 35-year-old female, with prediabetes, who presented to the emergency department with worsening right lower extremity (RLE) pain and edema following a febrile illness with pharyngitis. Throat swab on admission and subsequent blood cultures tested positive for beta-hemolytic GAS. Despite initial management for sepsis and cellulitis with myositis, she developed compartment syndrome requiring urgent fasciotomy. Her postoperative course was complicated by hypotension, toxic shock-like syndrome, menorrhagia, and transaminitis, but she ultimately recovered with IV antibiotics and stepwise Jacob's Ladder surgical wound closure. This report serves as the first known case of nontraumatic acute lower extremity compartment syndrome derived from disseminated GAS pharyngitis and may point to the development of novel virulence factor(s) for emerging strains of GAS in the United States. The case underscores the importance of recognizing GAS pharyngitis as a potential source of severe systemic infections, as early identification and aggressive management of invasive GAS infections may help prevent life-threatening complications.

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