Necrotizing Fasciitis caused by Streptococcus pyogenes: A case report and literature review of disease diagnosis and management
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Abstract
Background: A 55-year-old male presented to the emergency room at a local hospital complaining of chest discomfort and severe left elbow pain.
Case Presentation: Erythema and symptoms of peripheral neuropathy were evident in the left hand. The patient reported recent trauma to his left elbow; however a radiograph of the left arm was unremarkable for fracture. After being admitted to the intensive care unit for observation, he developed worsening pain out of proportion and progressive decreased sensation in his left hand.
Diagnosis: Initially, left arm compartment syndrome was suspected and treated accordingly. After surgical intervention, the patient’s subsequent symptoms and preliminary blood culture results revealed Gram positive cocci in chains, indicating necrotizing fasciitis. The isolate was identified as group A beta-hemolytic Streptococcus (GABS).
Treatment and Follow-up: Broad-spectrum antibiotics given at outset were extended with additional antibiotics. Treatment consisted of five separate surgeries involving extensive debridement of necrotic tissue amounting to approximately 55 to 65 percent of the patient’s body surface area. The patient was eventually released to a burn center for skin grafting and wound closure and in less than three months, he expired.
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Hidalgo-Grass C, Dan-Goor M, Maly A, Eran Y, Kwinn LA, et al. (2004) Effect of a bacterial pheromone peptide on host chemokine degradation in group A streptococcal necrotising soft-tissue infections. The Lancet 363, 696. Link: https://goo.gl/R78qw2
Kihiczak GG, Schwartz RA, Kapila R (2006) Necrotizing fasciitis: a deadly infection. J Eur Acad Dermatol Venereol 20: 365-369. Link: https://goo.gl/QLZjJF
Anderson JM (2011) Necrotizing fasciitis: An uncommon disease, frequently misdiagnosed. Journal of Controversial Medical Claims 11: 7-11. Link:
Vayvada H, Demirdover C, Menderes A, Karaca C (2012) [Necrotizing fasciitis: diagnosis, treatment and review of the literature]. Ulus Travma Acil Cerrahi Derg 18: 507-513. Link: https://goo.gl/5cbHfn
Stevens DL, Bisno AL, Chambers HF, Dellinger EP, Goldstein EJ, et al. (2005) Practice guidelines for the diagnosis and management of skin and soft-tissue infections. Clin Infect Dis 41, 1383-84. Link: https://goo.gl/WVoM2V
Olsen RJ, Shelburne SA, Musser JM (2009) Molecular mechanisms underlying group A streptococcal pathogenesis. Cell Microbiol 11: 4-9. Link: https://goo.gl/J2gNzC
Barillo DJ1, McManus AT, Cancio LC, Sofer A, Goodwin CW (2003) Burn center management of necrotizing fasciitis. J Burn Care Rehabil 24: 127-132. Link: https://goo.gl/ADLEYi
Swain RA, Hatcher JC, Azadian BS, et al. (2013) A five-year review of necrotising fasciitis in a tertiary referral unit. Ann R Coll Surg Engl 95: 57-60. Link: https://goo.gl/APGC19
McKenzie SB, Williams JL (2010) Clinical laboratory hematology, (2nd ed.) Upper Saddle river, NJ: Pearson, 386-387. Link: https://goo.gl/uh474H
Musialkowska E, Jedynak M, Klepacki A, Musiuk T, Wilkowska-Trojniel M, et al. (2010) Multifocal necrotizing fasciitis - case report. Adv Med Sci 55: 103-106. Link: https://goo.gl/FpuetM
Musser JM, Shelburne III SA (2009) A decade of molecular pathogenomic analysis of group A streptococcus. J Clin Invest 119: 2456-2463. Link: https://goo.gl/rKSghr