Acute compartment syndrome of the leg due to infection following an insect bite

Abstract

Rationale:Acute compartment syndrome is a highly aggressive condition, which needs rapid diagnosis and surgical emergency. Most cases are caused by trauma, fractures, surgeries, or vascular injury, while other causes are easily misdiagnosed.Patients concerns:A 29-year-old female, with a medical history of an insect bite on the left calf but not recent trauma, was admitted to the hospital due to the swelling and pain around the bite area.Diagnoses:Acute compartment syndrome of the lower leg.Interventions:After admission, she developed septic shock symptoms, given intravenous antibiotics treatments. However, the condition worsened with increasing pain, loss of sensation, tense swelling, and severe pain to any stretch of the tissues. Thus the patient received fasciotomy followed by repeat and thorough debridement. After the wounds healed completely, systematic rehabilitation was performed for three weeks.Outcomes:After three months of follow-up, the patient is able to walk, and moves up and down the stairs, independently.Lessons:Our case highlights the possibility of acute compartment syndrome caused by insect bites when the patient presents with the signs of the condition, and the importance of earlier rehabilitation interventions to improve the functional outcome post operation.

An Unusual Case of Osteomyelitis in a Pediatric Patient

“…[26] A case of compartment syndrome in the calf was also reported in a 29 year old woman. [27] Similar to the patient in the current case, these patients initially presented with pain and swelling in the affected area. In the case of the 29 year old woman, upon admission, she developed signs of septic shock including decreases consciousness, elevated WBC count, and elevated neutrophil count.…”

Idiopathic Acute Four-Compartment Syndrome of the Lower Leg

“…Other rarer causes of compartment syndrome include systemic diseases such as diabetes mellitus, HIV, hypothyroidism, hematogenous malignancy, systemic sclerosis, and neuroleptic psychiatric or statin medications. [1,8,9]. Our patient had a history of sarcoidosis with resulting rheumatoid-like arthropathy but given the patient's mild nature of these conditions and lack of evidence relating to the cause of compartment syndrome, it is unlikely the inciting factor in this patient's case.…”

Idiopathic Acute Compartment Syndrome of the Leg with Incidental Deep Venous Thrombosis: A Case Report

“…This is especially true in atraumatic cases, in which making a diagnosis of ACS may be more difficult [4, 5]. Common causes of atraumatic compartment syndromes have been reported including prolonged immobilization during surgery [6], insect and snake envenomation [7], hypothyroidism [8], long-standing uncontrolled diabetes [9, 10], occlusive acute deep vein thrombosis, use of anticoagulant therapy [11-13], and repetitive chronic trauma [14]. Our patient had no history of trauma and no recent history suggestive of any of the above possible etiologies leading to a delay in diagnosis.…”