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Post streptococcal myalgia: a subdiagnosed disorder- a case report

Cristina Ferreras, Francisca Aguiar, Margarida Tavares, Mariana Rodrigues, Iva Brito.

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Post streptococcal myalgia (PSM) is an underrecognized non-infectious sequela of streptococcal infection in children.
The authors report a case of PSM in a previously healthy 11-year-old girl admitted due to probable Streptococcal toxic shock syndrome (STSS) secondary to complicated periorbital cellulitis. Ten days after discharge, following steroid weaning for adverse drug reaction, she presented with low fevers associated with a painful swollen right forearm, with elevated inflammatory markers and normal muscle enzymes. MRI excluded infectious complications and showed simple myositis. PMS was suspected and the patient was treated with nonsteroidal anti-inflammatory drugs (NSAIDs) with progressive clinical and laboratory improvement. The clinical complaints were resolved 3 months later, without sequelae or recurrence.
The diagnosis of PSM should be considered in children presenting with acute myalgia and evidence of recent streptococcal infection

Key words: Post streptococcal myalgia, non-infectious sequelae, Streptococcal infection, Children

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