Non-Necrotizing Streptococcal Cellulitis as a Cause of Acute, Atraumatic Compartment Syndrome of the Foot: A Case Report

Toney, J.; Donovan, Stephanie; Adelman, Vanessa; Adelman, Ronald D.

doi:10.1053/j.jfas.2015.02.010

Cited by 12 publications

(7 citation statements)

References 16 publications

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“…[ 7 ] Other causes include burns, animal bites, bleeding disorders, and tight circumferential dressings. [ 8 ] Compared with high-energy trauma, infection caused by insect bites is considered rare, thus with the risk of being overlooked. It is important to be aware of the patient's medical histories when considering these unusual causes of compartment syndrome.…”

Section: Discussionmentioning

confidence: 99%

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

Wang¹,

Duan²,

Sun³

et al. 2018

Medicine

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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.

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Section: Discussionmentioning

confidence: 99%

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

Wang¹,

Duan²,

Sun³

et al. 2018

Medicine

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“…Various infectious organisms have been associated with local compartment syndrome. 3,4,9 However, this is the first report of a P mirabilis infection of a hematoma as a potential etiology. P mirabilis is a gramnegative bacilli species most commonly associated with opportunistic infections of the urinary tract and open wounds in immunocompromised individuals.…”

Section: Discussionmentioning

confidence: 85%

“…1 Hematoma and infection are 2 rare etiologies of insidious compartment syndrome that warrant a high index of suspicion. [2][3][4] Proteus mirabilis is a gram-negative species and an opportunistic pathogen that can infect the respiratory tract, the urinary tract, and open wounds. 5 To date, a Proteusinfected hematoma causing tissue necrosis and insidious compartment syndrome has not been reported in the English literature.…”

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confidence: 99%

Treatment of Atypical Compartment Syndrome Due to Proteus Infection

Stull¹,

Bhat²,

Miller³

et al. 2017

Orthopedics

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Compartment syndrome is an orthopedic emergency with a multitude of etiologies. Although it is most commonly associated with trauma to the extremity, hematoma and infection are 2 rare etiologies of insidious compartment syndrome. Proteus mirabilis is an opportunistic gram-negative species that can infect the respiratory tract, urinary tract, and open wounds. The authors present the case of a 69-year-old woman who developed tissue necrosis and compartment syndrome secondary to an untreated hematoma infected by P mirabilis. This case involves an atypical presentation caused by an untreated infected hematoma, emphasizing the need for a high index of suspicion. Current literature supports immediate surgical intervention in the clinical scenario of fulminant compartment syndrome, regardless of compartment pressure findings. The probability of compartment syndrome in the patient presenting with pain, paresthesias, paresis, and pain with passive stretch, all of which were positive findings in this patient, has been reported to be 98%. Thus, Doppler evaluation and intercompartmental pressures were considered but forgone to expedite operative treatment. Emergent 4-compartment fasciotomies, with excision and debridement of nonviable tissue, are potentially limb-saving procedures, intended to limit loss of function and obviate the need for lower extremity amputation. The decision was made to perform a dual-incision fasciotomy to avoid contamination of the uninvolved compartments with a standard single-incision approach. To date, this represents the first report in the English literature of the insidious onset of tissue necrosis secondary to a Proteus-infected hematoma, highlighting a unique etiology of atypical compartment syndrome. [Orthopedics. 2017; 40(1):e176-e178.].

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“…Severe local limb infection, including necrotising fasciitis, may also lead to ALCS in association with infective signs 41 . Non‐necrotising fasciitis, cellulitis and sepsis were also reported 42,43 . Group A Streptococci and Staphylococcus aureus account for most reports, but atypical organisms such as Vibrio , Clostridium and Proteus species are also documented.…”

Section: Discussionmentioning

confidence: 99%

Review article: A comprehensive review of unusual causes of acute limb compartment syndrome

Steadman

Hamilton

et al. 2022

Emerg Medicine Australasia

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Acute limb compartment syndrome (ALCS) is a surgical emergency that can have serious consequences unless promptly diagnosed and treated, which is particularly challenging when there is an unusual cause. This is a comprehensive review of reported causes of ALCS. From 1068 included articles, we found 299 discrete causes of ALCS including toxins, infections, endocrine pathology, haematological emergencies, malignancy and iatrogenic ALCS. Familiarity with this wide range of ALCS causes may assist in early diagnosis of this limb-threatening condition.

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Non-Necrotizing Streptococcal Cellulitis as a Cause of Acute, Atraumatic Compartment Syndrome of the Foot: A Case Report

Cited by 12 publications

References 16 publications

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

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

Treatment of Atypical Compartment Syndrome Due to Proteus Infection

Review article: A comprehensive review of unusual causes of acute limb compartment syndrome

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