Crtical Care and Shock Journal

An Unusual Presentation of Staphylococcal Induced Paravertebral Myositis Causing Septic Shock

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Background: Paravertebral myositis is uncommon, and this case highlights a number of important therapeutic and diagnostic considerations. We discuss the role of appropriate antimicrobial therapy and the potential dilemma regarding the use of immunoglobulin in the septic patient. The key elements of treatment are early recognition, and the early initiation of appropriate antibiotics, typically a β-lactamase resistant anti-staphylococcal agent and clindamycin. Clindamycin is added to anti-staphylococcal treatment due to its ability to reduce exotoxin production, a result of its ability to suppress translation of toxin genes.
Methods: We present a case report of a Staphylococcus aureus (S. aureus) induced paravertebral myositis resulting in septic shock.
Conclusions: It remains that the role of IVIG in the management of sepsis is as yet not clearly defined, at present it is neither advocated nor dismissed by current guidelines, given the presence of both positive and negative findings in recent metaanalysis.

J. O’Leary, M. Kelleher, C. Motherway


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June 2024, Volume 27 Number 3
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