Case Report

Published: Oct 29, 2025 | DOI: 10.24911/ejmcr.9-2308

Rapid-onset group A streptococcal pyomyositis after minor blunt leg trauma in an immunocompetent adult: a case report


Authors: Ketankumar Vegad orcid logo , Deeksha Deepak orcid logo


Article Info

Authors

Ketankumar Vegad

Aneurin Bevan University Health Board, Ysbyty Ystrad Fawr, Hengoed, UK

orcid logo ORCID

Deeksha Deepak

Aneurin Bevan University Health Board, Ysbyty Ystrad Fawr, Hengoed, UK

orcid logo ORCID

Publication History

Received: August 28, 2025

Accepted: September 23, 2025

Published: October 29, 2025


Abstract


Background: Pyomyositis is uncommon in temperate regions and is usually caused by Staphylococcus aureus. Infections due to group A Streptococcus (GAS) are rare but can progress rapidly.

Case Presentation: A healthy 50-year-old man presented with a three-day history of left-calf pain and swelling two days after minor blunt trauma. He was tachycardic but normothermic. Work-up for thrombosis and cellulitis showed leukocytosis (24.9 × 10^9/L) and C-reactive protein 436 mg/L; Doppler leg ultrasonography and chest computed tomography (CT) were unremarkable. Within 18 hours, the limb became tense with new blisters and systemic instability. Urgent limb CT revealed extensive subcutaneous edema and fascial fluid. Fasciotomy identified intramuscular abscesses without necrotizing fasciitis. Cultures grew GAS sensitive to penicillin. Broad-spectrum intravenous antibiotics were streamlined to benzyl-penicillin, meropenem, and metronidazole; two weeks of intravenous therapy followed by two weeks of oral co-amoxiclav achieved near complete recovery.

Conclusions: GAS pyomyositis can transform mild limb discomfort into sepsis within hours, even in immunocompetent adults. Disproportionate tachycardia, rapidly spreading swelling or blistering, and escalating inflammatory markers warrant early cross-sectional imaging, multidisciplinary review, and prompt operative exploration. Vigilant reassessment and decisive intervention were critical to the favorable outcome in this case and may reduce morbidity in similar rapidly progressive infections.


Keywords: Group A Streptococcus, Pyomyositis, Temperate, Tropical, Trauma & Orthopedic, case report


Pubmed Style

Ketankumar Vegad, Deeksha Deepak. Rapid-onset group A streptococcal pyomyositis after minor blunt leg trauma in an immunocompetent adult: a case report. EJMCR. 2025; 29 (October 2025): -. doi:10.24911/ejmcr.9-2308

Web Style

Ketankumar Vegad, Deeksha Deepak. Rapid-onset group A streptococcal pyomyositis after minor blunt leg trauma in an immunocompetent adult: a case report. https://www.ejmcr.com/index.php/articles/2308 [Access: November 06, 2025]. doi:10.24911/ejmcr.9-2308

AMA (American Medical Association) Style

Ketankumar Vegad, Deeksha Deepak. Rapid-onset group A streptococcal pyomyositis after minor blunt leg trauma in an immunocompetent adult: a case report. EJMCR. 2025; 29 (October 2025): -. doi:10.24911/ejmcr.9-2308

Vancouver/ICMJE Style

Ketankumar Vegad, Deeksha Deepak. Rapid-onset group A streptococcal pyomyositis after minor blunt leg trauma in an immunocompetent adult: a case report. EJMCR. (2025), [cited November 06, 2025]; 29 (October 2025): -. doi:10.24911/ejmcr.9-2308

Harvard Style

Ketankumar Vegad, Deeksha Deepak (2025) Rapid-onset group A streptococcal pyomyositis after minor blunt leg trauma in an immunocompetent adult: a case report. EJMCR, 29 (October 2025): -. doi:10.24911/ejmcr.9-2308

Chicago Style

Ketankumar Vegad, Deeksha Deepak. "Rapid-onset group A streptococcal pyomyositis after minor blunt leg trauma in an immunocompetent adult: a case report." 29 (2025), -. doi:10.24911/ejmcr.9-2308

MLA (The Modern Language Association) Style

Ketankumar Vegad, Deeksha Deepak. "Rapid-onset group A streptococcal pyomyositis after minor blunt leg trauma in an immunocompetent adult: a case report." 29.October 2025 (2025), -. Print. doi:10.24911/ejmcr.9-2308

APA (American Psychological Association) Style

Ketankumar Vegad, Deeksha Deepak (2025) Rapid-onset group A streptococcal pyomyositis after minor blunt leg trauma in an immunocompetent adult: a case report. , 29 (October 2025), -. doi:10.24911/ejmcr.9-2308