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<p>Invasive soft tissue infections caused by <i>Streptococcus pyogenes</i> are pathologies with high morbidity and mortality. Depending on the tissue primarily affected, two clinical entities are described: necrotizing fasciitis and streptococcal myositis. This study presents the case of a&#xa0;39-year-old male patient who attended the emergency department with fever, swelling, and pain of the left shoulder for 24 h. Examination showed disproportionate pain in the left axillary and pectoral area as well as tachycardia and a&#xa0;temperature of 39 °C. Laboratory tests revealed increased acute-phase reactants and leukocytosis. Imaging tests showed inflammation and muscle edema suggestive of myositis or pyomyositis. The area was surgically debrided, with findings compatible with early left pectoral and thoracic myositis or fasciitis. <i>Streptococcus pyogenes</i> was found in the surgical samples. The patient’s course progressed positively after surgery and targeted antibiotic therapy. High diagnostic suspicion is necessary in early stages of infection, where necrotizing fasciitis and streptococcal myositis may present similar clinical features.</p>

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Necrotizing fasciitis vs. streptococcal myositis in a manual worker: a case report

  • 期刊论文

  • 发表日期：

    2025年2月27日

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  • Alberto Flores Meca,
  • M. Teresa Pérez Pérez,
  • Antonio Rodríguez Rodríguez

摘要

Invasive soft tissue infections caused by Streptococcus pyogenes are pathologies with high morbidity and mortality. Depending on the tissue primarily affected, two clinical entities are described: necrotizing fasciitis and streptococcal myositis. This study presents the case of a 39-year-old male patient who attended the emergency department with fever, swelling, and pain of the left shoulder for 24 h. Examination showed disproportionate pain in the left axillary and pectoral area as well as tachycardia and a temperature of 39 °C. Laboratory tests revealed increased acute-phase reactants and leukocytosis. Imaging tests showed inflammation and muscle edema suggestive of myositis or pyomyositis. The area was surgically debrided, with findings compatible with early left pectoral and thoracic myositis or fasciitis. Streptococcus pyogenes was found in the surgical samples. The patient’s course progressed positively after surgery and targeted antibiotic therapy. High diagnostic suspicion is necessary in early stages of infection, where necrotizing fasciitis and streptococcal myositis may present similar clinical features.