ABSTRACT
Streptococcal toxic shocklike syndrome is caused by group A streptococci and characterized by multiorgan failure and soft-tissue necrosis, often in young patients with a bland history and at most a minor trauma. Diagnosis is reached through the clinical presentation, imaging methods and positive bacterial verification. The course is fulminant and in the case of muscle involvement, mortality reaches 80-100%. Therapy consists of immediate fasciotomy and often of debridement of affected soft tissues with high-dose antibiotics in intensive care. Sometimes an unconfirmed diagnosis must be sufficient to operate. We report the case of a 29-year-old man without an exceptional history who was forced to undergo thigh amputation, multiple soft-tissue debridements, and after a total of 240 erythrocyte concentrates, finally hip joint enucleation.
Subject(s)
Myositis/etiology , Myositis/surgery , Shock, Septic/diagnosis , Streptococcal Infections/diagnosis , Streptococcus pyogenes , Adult , Amputation, Surgical , Diagnosis, Differential , Hip Joint/surgery , Humans , Male , Thigh/surgeryABSTRACT
Gastrointestinal tuberculosis is a rare disease in industrial countries. The most frequent localisation is the ileocaecal region. We report about two cases of stenotic ileocaecal tuberculosis, treated by surgical resection. The main clinical symptoms are abdominal pain, weight loss and low-grade fever. Uncomplicated cases responses successfully to antituberculous drugs, just complications require surgery.
