A case of dropped head syndrome due to focal myositis that worsened with cellulitis and improved only by treatment of cellulitis

Abstract

Dropped head syndrome due to focal myositis is extremely rare. Due to the rarity of the disease, its clinical characteristics and prognosis remain unknown. We present a unique case of dropped head syndrome due to focal myositis that exacerbated following cellulitis and was dramatically improved along with the improvement of her cellulitis only treated with antibiotics. We should consider the possibility of preceding trigger event such as infection when we face with the exacerbation of focal myositis before making a decision of strengthening immunosuppressive therapy to avoid unnecessary increase of glucocorticoid.

Keywords:

• Myositis
• focal myositis
• dropped head
• dropped head syndrome
• infection

Patient consent

Written informed consent for publication of this report was obtained from the patient by the author.

Ethical approval

Not applicable.

Conflict of interest

M.A. M.O. and S.M. report no conflicts of interest. Yu.K. has received grants or speaker fees from AbbVie, Astellas, Ayumi, Bristol-Myers Squibb, Chugai, Eisai, Eli Lilly, Hisamitsu, Jansen, Kissei, Pfizer, Sanofi, Takeda, Tanabe-Mitsubishi and UCB. S.S. has received speaking fees from Chugai Pharmaceutical Co., Ltd., Eisai Co., Ltd., Pfizer Japan Inc., Asahi Kasei Pharma Corporation, Bristol Myers Squibb Co., and Mitsubishi Tanabe Pharma Corporation. K.M. has received grants from GlaxoSmithKline K.K. Ya. K. has received speaker fees from Chugai Pharmaceutical Co., Ltd., Abbvie Co., Ltd., Astellas Pharma Inc., Asahi Kasei Pharma Corporation and Sanofi Japan. H.H. has received speaker fees from AbbVie, Asahi Kasei, Astellas, Bristol-Myers Squibb, Chugai, Eli Lilly, Glaxo SmithKline, Jansen, Novartis, Pfizer, Sanofi, Tanabe-Mitsubishi, and UCB. K.O. has received speaker fees from AbbVie, Asahi Kasei, Astellas, Bristol-Myers Squibb, Chugai, Eli Lilly, Glaxo SmithKline, Jansen, Novartis, Pfizer, Sanofi, Tanabe-Mitsubishi, and UCB. T.T. has received research grants or speaking fees from Astellas Pharma Inc., Bristol–Myers K.K., Chugai Pharmaceutical Co, Ltd, Daiichi Sankyo Co., Ltd, Takeda Pharmaceutical Co., Ltd, Teijin Pharma Ltd, AbbVie GK, Asahi Kasei Pharma Corp., Mitsubishi Tanabe Pharma, Astra Zeneca K.K., Eli Lilly Japan K.K., Novartis Pharma K.K., AbbVie GK, Nippon Kayaku Co. Ltd, Janssen Pharmaceutical K.K., Taiho Pharmaceutical Co., Ltd., and Pfizer Japan Inc.