Research Article

Myocardial depression in streptococcal cellulitis.

Br Med J (Clin Res Ed) 1984; 288 doi: https://doi.org/10.1136/bmj.288.6420.816 (Published 17 March 1984) Cite this as: Br Med J (Clin Res Ed) 1984;288:816
  1. J D Edwards,
  2. P M Schofield

    Abstract

    A previously healthy woman developed streptococcal cellulitis of the leg after falling and lacerating her knee. On admission her blood pressure was unrecordable and her respiratory rate greater than 60 beats/minute. Mechanical ventilation was necessary, and plasma volume expansion was started, with little effect. Infusion of dopamine restored the blood pressure to 150/90 mm Hg, but interrupting the infusion for as little as 30 seconds resulted in profound hypotension. Insertion of a second central venous catheter allowed the dopamine to be given continuously, and the infusion was stopped successfully four days after her admission. She eventually made a complete recovery. This case highlights the need for intensive supportive treatment in many streptococcal infections and, in particular, the need for inotropic support.