Upper limb compartment syndrome secondary to streptococcus pyogenes (Group A streptococcus) infection

Taylor, Joan du Plat; Wojcik, Andrew

doi:10.1093/jscr/2011.3.3

Cited by 7 publications

(7 citation statements)

References 9 publications

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“…Patients with acute compartment syndrome typically present with pain that appears to be out of proportion to their injury [ 7 ]. Additionally, other common clinical features of compartment syndrome include pallor, paresthesia, pulselessness, and pain upon passive range of motion [ 2 , 5 ].…”

Section: Discussionmentioning

confidence: 99%

“…Acute compartment syndrome is an emergent surgical condition in which a compartment, an anatomical area bounded by fascia and bone, develops increased pressure and diminished vascular supply [ 1 ]. It is primarily associated with traumatic extremity fractures, but can also occur with burns, infections, and prolonged limb compression [ 1 , 2 ]. Failure to diagnose acute compartment syndrome can result in serious limb-threatening complications such as deformity, paralysis, and amputation [ 3 ].…”

Section: Introductionmentioning

confidence: 99%

“…Cellulitis is a bacterial skin infection that is caused by pathogens entering through breaks in the skin [ 4 ]. One pathogen responsible for many cases of cellulitis is Streptococcus pyo-genes (Group A Streptococcus), a gram-positive coccus that is noted to be among the most common human pathogens [ 2 , 4 ]. Streptococcal infection has been noted to be a rare but possible cause of acute compartment syndrome, and management in these cases includes prompt surgical intervention and intravenous antibiotic treatment [ 2 , 3 , 5 , 6 ].…”

Section: Introductionmentioning

confidence: 99%

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An 84-Year-Old Man with Acute Atraumatic Compartment Syndrome of the Upper Extremity Due to Streptococcus pyogenes Cellulitis

2021

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Patient: Male, 84-year-old Final Diagnosis: Compartment syndrome Symptoms: Arm pain • arm swelling Medication: — Clinical Procedure: Fasciotomy Specialty: Surgery Objective: Unusual clinical course Background: Acute compartment syndrome represents a surgical emergency to restore blood supply by fasciotomy and decompression. Compartment syndrome is most commonly associated with crush-related injuries and fractures; however, other non-traumatic etiologies can occur. This report illustrates a rare case of acute atraumatic compartment syndrome of the upper extremity due to Streptococcus pyogenes cellulitis in an 84-year-old man, presenting a challenging clinical scenario. Case Report: An 84-year-old man presented to the Emergency Department with 24 h of significant right-arm pain and swelling. Due to the amount of increased swelling and significant pain, compartment pressure was obtained. He underwent emergency fasciotomy of his right forearm, hand, and carpal tunnel release. Both blood and intra-operative wound cultures grew Streptococcus pyogenes (Group A Streptococcus). The patient suffered a prolonged hospital course requiring multiple subsequent surgeries and eventual skin grafting. Despite his complicated hospital course, he made a remarkable recovery and was discharged home in excellent condition. Conclusions: This report illustrates that compartment syndrome should be considered as a complication of cellulitis in patients with severe pain, even without a history of trauma. Early diagnosis, antibiotic therapy, and emergency fasciotomy are required to preserve the affected limb.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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An 84-Year-Old Man with Acute Atraumatic Compartment Syndrome of the Upper Extremity Due to Streptococcus pyogenes Cellulitis

2021

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“…GAS migration to the local draining lymph node was increased when a mild contusion force was applied at the same time as bacterial inoculation. The findings may be of relevance not only to contusion injury and compartment syndromes, which are recognized to be associated with serious iGAS infections [1,33], but also to the application of compression bandaging in lymphoedema. While this is recognized to enhance lymphatic drainage and overall tissue viability in the lower limb, caution may be required in the context of a more virulent bacterial infection such as GAS until it is known whether such bacterial transit promotes or prevents systemic dissemination.…”

Section: Discussionmentioning

confidence: 99%

Impact of contusion injury on intramuscular emm1 group a streptococcus infection and lymphatic spread

Siggins

Scudamore

et al. 2018

Virulence

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Invasive group A Streptococcus (iGAS) is frequently associated with emm1 isolates, with an attendant mortality of around 20%. Cases occasionally arise in previously healthy individuals with a history of upper respiratory tract infection, soft tissue contusion, and no obvious portal of entry. Using a new murine model of contusion, we determined the impact of contusion on iGAS bacterial burden and phenotype.Calibrated mild blunt contusion did not provide a focus for initiation or seeding of GAS that was detectable following systemic GAS bacteremia, but instead enhanced GAS migration to the local draining lymph node following GAS inoculation at the same time and site of contusion. Increased migration to lymph node was associated with emergence of mucoid bacteria, although was not specific to mucoid bacteria. In one study, mucoid colonies demonstrated a significant increase in capsular hyaluronan that was not linked to a covRS or rocA mutation, but to a deletion in the promoter of the capsule synthesis locus, hasABC, resulting in a strain with increased fitness for lymph node migration.In summary, in the mild contusion model used, we could not detect seeding of muscle by GAS. Contusion promoted bacterial transit to the local lymph node. The consequences of contusion-associated bacterial lymphatic migration may vary depending on the pathogen and virulence traits selected.

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“…When it is found in other parts of the body, it is usually associated with higher virulence. The review of literature reveals cases of trauma-induced GAS compartment syndrome causing either ipsilateral upper limb compartment syndrome (1) or lower limb unilateral compartment syndrome (2). Cases of lower bilateral compartment syndrome from GAS were more commonly reported as having a non-traumatic origin (3, 4).…”

Section: Discussionmentioning

confidence: 99%

Contralateral compartment syndrome inoculated by invasive group A streptococcus

Chen

McPhillips

Chundi

2016

Journal of Community Hospital Internal Medicine Perspectives

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Compartment syndrome is a rare but a well-documented complication in patients with trauma-induced group A streptococcus infection. Here, we present a case of a male who developed compartment syndrome on the left lower extremity after an injury inoculated by group A streptococcus on the right lower extremity. The patient was resuscitated with antibiotics, urgent fasciotomy, and immunoglobulin. The patient was eventually transferred to a burn center for further care.

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Upper limb compartment syndrome secondary to streptococcus pyogenes (Group A streptococcus) infection

Cited by 7 publications

References 9 publications

An 84-Year-Old Man with Acute Atraumatic Compartment Syndrome of the Upper Extremity Due to Streptococcus pyogenes Cellulitis

An 84-Year-Old Man with Acute Atraumatic Compartment Syndrome of the Upper Extremity Due to Streptococcus pyogenes Cellulitis

Impact of contusion injury on intramuscular emm1 group a streptococcus infection and lymphatic spread

Contralateral compartment syndrome inoculated by invasive group A streptococcus

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