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CT also showed densification of the gluteal muscles, multiple air bubbles in the psoas, paraspinal muscles and spinal canal that were associated with an intramuscular injection administered 1\u2009week earlier for a backache. After escalation of the antibiotherapy and intensive supportive measures, the patient showed improvement and was discharged after 8 weeks of antibiotherapy.<\/jats:p>\n               <jats:p>The incidence of invasive SDSE infections has been growing, especially in immunosupressed patients. In this case, despite no predisposing factor identified, it evolved to severe sepsis. The intramuscular injection, a trivialised but not harmless procedure, was the assumed port of entry, as previously described in another case report.<\/jats:p>","DOI":"10.1136\/bcr-2017-220336","type":"journal-article","created":{"date-parts":[[2017,7,19]],"date-time":"2017-07-19T08:50:22Z","timestamp":1500454222000},"page":"bcr-2017-220336","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":4,"title":["Multifocal septic arthritis, gluteal abscess and spondylodiscitis by <i>Streptococcus dysgalactiae<\/i> subspecies <i>equisimilis<\/i> after an intramuscular injection"],"prefix":"10.1136","volume":"2017","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3485-2098","authenticated-orcid":false,"given":"Rita Marques","family":"Pocinho","sequence":"first","affiliation":[{"name":"Department of Medicina 1.2, Hospital de S\u00e3o Jos\u00e9, Centro Hospitalar Lisboa Central, Lisboa, Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Liliana","family":"Antunes","sequence":"additional","affiliation":[{"name":"Department of Medicina 1.2, Hospital de S\u00e3o Jos\u00e9, Centro Hospitalar Lisboa Central, Lisboa, Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pedro","family":"Pires","sequence":"additional","affiliation":[{"name":"Department of Medicina 1.2, Hospital de S\u00e3o Jos\u00e9, Centro Hospitalar Lisboa Central, Lisboa, Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Isabel","family":"Baptista","sequence":"additional","affiliation":[{"name":"Department of Medicina 1.2, Hospital de S\u00e3o Jos\u00e9, Centro Hospitalar Lisboa Central, Lisboa, Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2017,7,19]]},"reference":[{"key":"2025082700461618000_2017.jul19_1.bcr-2017-220336.1","doi-asserted-by":"publisher","DOI":"10.1086\/605085"},{"key":"2025082700461618000_2017.jul19_1.bcr-2017-220336.2","doi-asserted-by":"publisher","DOI":"10.1007\/s10096-014-2092-0"},{"key":"2025082700461618000_2017.jul19_1.bcr-2017-220336.3","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.01262-13"},{"key":"2025082700461618000_2017.jul19_1.bcr-2017-220336.4","doi-asserted-by":"publisher","DOI":"10.1084\/jem.57.4.571"},{"key":"2025082700461618000_2017.jul19_1.bcr-2017-220336.5","doi-asserted-by":"publisher","DOI":"10.1099\/00207713-46-3-774"},{"key":"2025082700461618000_2017.jul19_1.bcr-2017-220336.6","doi-asserted-by":"publisher","DOI":"10.3201\/eid1008.030840"},{"key":"2025082700461618000_2017.jul19_1.bcr-2017-220336.7","doi-asserted-by":"publisher","DOI":"10.1086\/597035"},{"key":"2025082700461618000_2017.jul19_1.bcr-2017-220336.8","doi-asserted-by":"publisher","DOI":"10.1093\/clinids\/5.2.196"},{"key":"2025082700461618000_2017.jul19_1.bcr-2017-220336.9","doi-asserted-by":"publisher","DOI":"10.1111\/j.1469-0691.2008.02672.x"},{"key":"2025082700461618000_2017.jul19_1.bcr-2017-220336.10","doi-asserted-by":"publisher","DOI":"10.1007\/s10156-012-0375-x"},{"key":"2025082700461618000_2017.jul19_1.bcr-2017-220336.11","doi-asserted-by":"publisher","DOI":"10.2169\/internalmedicine.52.8846"},{"key":"2025082700461618000_2017.jul19_1.bcr-2017-220336.12","doi-asserted-by":"crossref","first-page":"127","DOI":"10.3201\/eid2301.161009","article-title":"Streptococcal toxic shock syndrome caused by group G streptococcus, United Kingdom","volume":"23","author":"Baxter","year":"2017","journal-title":"Emerg Infect Dis"},{"key":"2025082700461618000_2017.jul19_1.bcr-2017-220336.13","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.42.1.186-192.2004"},{"key":"2025082700461618000_2017.jul19_1.bcr-2017-220336.14","first-page":"789","article-title":"Unsafe injections in the developing world and transmission of bloodborne pathogens: a review","volume":"77","author":"Simonsen","year":"1999","journal-title":"Bull World Health Organ"},{"key":"2025082700461618000_2017.jul19_1.bcr-2017-220336.15","first-page":"801","article-title":"Transmission of hepatitis B, hepatitis C and human immunodeficiency viruses through unsafe injections in the developing world: model-based regional estimates","volume":"77","author":"Kane","year":"1999","journal-title":"Bull World Health Organ"},{"key":"2025082700461618000_2017.jul19_1.bcr-2017-220336.16","unstructured":"Organization WH. 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