Immunodeficiency as a side effect of anabolic androgenic steroid abuse: a case of necrotizing myofasciitis

Forensic Sci Med Pathol. 2019 Dec;15(4):616-621. doi: 10.1007/s12024-019-00144-z. Epub 2019 Jul 29.


Even if there are well-known consequences of anabolic androgenic steroid (AAS) abuse, their full pathway of action is still being investigated. In this context, the presented case report aims to discuss and provide evidence of unusual adverse effects linked to immunodeficiency in an AAS abuser. In fact, this kind of chronic complication, even if not usually considered, may lead sudden death. In this case a 31-year-old aesthetic weightlifter, who presented to the emergency department due to an accidental fall that resulted in left thigh trauma. This subsequently developed into left thigh necrotizing myofasciitis in the following few days. Although surgery and hyperbaric therapy were carried out, the man died. An autopsy with complete biological sampling for toxicological studies was performed. This case highlights the close relationship between AAS abuse and immunodeficiency and highlights it's importance for further studies. However, it should be considered that of all the dangerous effects produced by AAS use, necrotizing fasciitis is not such an unusual consequence.

Keywords: Anabolic androgenic steroids; Forensic science; Necrotizing fasciitis; Secondary immunodeficiency.

Publication types

  • Case Reports

MeSH terms

  • Accidental Falls
  • Adult
  • Anabolic Agents / administration & dosage
  • Anabolic Agents / adverse effects*
  • Fasciitis, Necrotizing / etiology*
  • Fasciitis, Necrotizing / pathology
  • Fatal Outcome
  • Humans
  • Immunocompromised Host*
  • Injections, Intramuscular
  • Male
  • Myositis / etiology*
  • Myositis / pathology
  • Substance-Related Disorders / complications*
  • Thigh
  • Weight Lifting


  • Anabolic Agents