Necrotizing myositis: Difference between revisions
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==Background== | ==Background== | ||
* Much rarer than [[Necrotizing fasciitis]] | *Much rarer than [[Necrotizing fasciitis]] | ||
* May be preceded by skin abrasions, blunt trauma, heavy exercise | *May be preceded by skin abrasions, blunt trauma, heavy exercise | ||
* Most patients are otherwise healthy (DM and other underlying conditions do not appear to increase risk) | *Most patients are otherwise healthy (DM and other underlying conditions do not appear to increase risk) | ||
==Clinical Features== | ==Clinical Features== | ||
*Exquisite pain and swelling of affected muscle with induration | *Exquisite pain and swelling of affected muscle with induration | ||
*Overlying skin changes may manifest later in the course of illness (erythema, warmth, petechiae, bullae) | *Overlying skin changes may manifest later in the course of illness (erythema, warmth, petechiae, bullae) | ||
*Hypotension may occur rapidly with development of streptococcal toxic shock syndrome | *[[Hypotension]]may occur rapidly with development of streptococcal toxic shock syndrome | ||
==Differential Diagnosis== | ==Differential Diagnosis== | ||
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{{Necrotizing Rashes DDX}} | {{Necrotizing Rashes DDX}} | ||
== | ==Evaluation== | ||
==Management== | ==Management== | ||
* Same as [[Necrotizing Fasciitis]] | *Same as [[Necrotizing Fasciitis]] | ||
==Disposition== | ==Disposition== | ||
Latest revision as of 14:41, 10 March 2017
Background
- Much rarer than Necrotizing fasciitis
- May be preceded by skin abrasions, blunt trauma, heavy exercise
- Most patients are otherwise healthy (DM and other underlying conditions do not appear to increase risk)
Clinical Features
- Exquisite pain and swelling of affected muscle with induration
- Overlying skin changes may manifest later in the course of illness (erythema, warmth, petechiae, bullae)
- Hypotensionmay occur rapidly with development of streptococcal toxic shock syndrome
Differential Diagnosis
Skin and Soft Tissue Infection
- Cellulitis
- Erysipelas
- Lymphangitis
- Folliculitis
- Hidradenitis suppurativa
- Skin abscess
- Necrotizing soft tissue infections
- Mycobacterium marinum
Look-A-Likes
- Sporotrichosis
- Osteomyelitis
- Deep venous thrombosis
- Pyomyositis
- Purple glove syndrome
- Tuberculosis (tuberculous inflammation of the skin)
Necrotizing rashes
- Necrotizing soft tissue infections
- Purpura fulminans
- Drug rash
- Levamisole toxicity
- Heparin-induced skin necrosis
- Warfarin-induced skin necrosis
Evaluation
Management
- Same as Necrotizing Fasciitis
Disposition
- Admit/OR