Case Report
Right Arm Pyomyositis and Necrotizing Fasciitis Complicated With Subcutaneous Emphysema and Pneumomediastinum in a Patient With Diabetes Mellitus and Iatrogenic Cushing Syndrome
Abstract
We report a case of subcutaneous emphysema and pneumomediastinum secondary to pyomyositis and necrotizing fasciitis over the right arm of a woman with underlying diabetes mellitus and iatrogenic Cushing syndrome. Gas produced by the culprit pathogen extensively dissected the subcutaneous fat and fascia of the patient’s right arm and distantly spread to her face, neck, back, and thoracic wall and penetrated the soft tissue cephalically bordering her sternum, resulting in pneumomediastinum. The patient improved with antimicrobial therapy and localized debridement and fasciotomy over her right arm.
Key Points
* Pyomyositis and necrotizing fasciitis of the right arm led to subcutaneous emphysema and pneumomediastinum in a diabetic patient with iatrogenic Cushing syndrome.
* Localized debridement and fasciotomy over the right arm coupled with antibiotic therapy cured the patient, and the pneumomediastinum disappeared.
This content is limited to qualifying members.
Existing members, please login first
If you have an existing account please login now to access this article or view purchase options.
Purchase only this article ($25)
Create a free account, then purchase this article to download or access it online for 24 hours.
Purchase an SMJ online subscription ($75)
Create a free account, then purchase a subscription to get complete access to all articles for a full year.
Purchase a membership plan (fees vary)
Premium members can access all articles plus recieve many more benefits. View all membership plans and benefit packages.