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Indexed/Abstracted in: BIOSIS Previews, EMBASE, Scopus, Emerging Sources Citation Index
Online ISSN 1827-1812
Colombo G. M., Pace F., Levi Della Vida A.
Emergency Medicine Unit, San Camillo Hospital, Rome, Italy
A 72-year-old woman was admitted to Emergency Department (ED) for fever, severe muscle weakness and whole body myalgia. Her past medical history included hypertension, non insulin-dependent diabetes mellitus and surgical intervention for breast bilateral cancer with a right breast implant six years before. On admission physical examination showed only muscle weakness in the extremities and laboratory data revealed severe rhabdomyolysis, lactic acidosis and acute renal failure. Although aggressive therapy with fluids, bicarbonate ad broad spectrum antibiotics were administered, patient’s general and neurological conditions rapidly worsened and she died two days after admission for septic shock. Post mortem examination revealed an abscess of the anterior muscular chest wall, behind the right breast implant, while a streptococcus dysagalactiae (group C streptococcus; GCS) grew from blood cultures. A diagnosis of fatal toxic shock syndrome (TSS) secondary to infectious rhabdomyolysis due to GCS was made.