Streptococcus anginosus (SAG) is a known human pathogen and member of the Streptococcus milleri group. SAG is a known bacterial cause of soft-tissue abscesses and bacteremia and is an increasingly prevalent pathogen in infections in patients with cystic fibrosis. We describe a rare case of SAG as an infectious agent in a case of nonclostridial myonecrosis with soft-tissue emphysema. This is the only case found in the literature of SAG cultured as a pure isolate in this type of infection and was associated with a prolonged course of treatment in an otherwise healthy patient.
Leiomyosarcoma is a very rare malignant tumor, with only 28 new cases diagnosed in the United States each year. The prognosis varies, with average 5-year survival of 65%. Although most leiomyosarcomas occur in the lower extremity, there is a paucity in the literature on these sarcomas in the foot. Only 15 cases of leiomyosarcoma in the foot have been reported in the literature since the mid-1930s. We describe a 31-year-old man with a history of an ingrown toenail and nonhealing pyogenic granuloma. His clinical presentation suggested atypical tissue. Biopsy findings confirmed the diagnosis of spindle cell sarcoma, specifically, leiomyosarcoma. The patient was treated with amputation of the affected hallux and adjuvant therapy. The similar presentations of a pyogenic granuloma and a malignant tumor necessitate a thorough differential diagnosis with even common foot ailments. (J Am Podiatr Med Assoc 97(6): 475–479, 2007)