Acute anterior compartment syndrome secondary to group A beta-hemolytic streptococcal myositis.

Compartment syndrome, the acute elevation of pressure within the fascial compartment of a muscle above that needed for capillary perfusion, is almost always associated with trauma. Infection, however, has been reported to cause this pressure phenomenon as well, as can excessive exercise, which is simply repeated microtrauma. Infectious causes of compartment syndrome have been previously reported by Dannemann, et al. in 1984,1 Bohn and Coleman in 1985,2 and by Knezevich and Torch in 1990.3 As the muscle swells in response to these insults, the muscle volume can increase by as much as 20 percent.4 The fascial compartments are nondistensible, so this increased volume is accompanied by increased pressure. Venous stasis is followed by frank ischemia. Inflammatory mediators are then released, causing further swelling. If left unchecked, muscle necrosis eventually develops. Compartment syndrome usually responds favorably to fasciotomy if performed promptly.4,5 We report a case of compartment syndrome caused by acute group A ~-hemolytic streptococcal myositis.