scholarly journals Severe form of streptococcal necrotizing fasciitis of the upper limb - diagnostic and therapeutic challenge: A case report

2015 ◽  
Vol 72 (8) ◽  
pp. 745-749 ◽  
Author(s):  
Dragan Mikic ◽  
Tatjana Takic-Radovanovic ◽  
Milan Lukovic ◽  
Milomir Kosutic ◽  
Srdjan Starcevic ◽  
...  
Keyword(s):  
Case Report ◽  
Necrotizing Fasciitis ◽  
Upper Limb ◽  
Group A Streptococcus ◽  
Multidisciplinary Treatment ◽  
Severe Form ◽  
Limb Amputation ◽  
Streptococcus Group ◽  
Left Hand ◽  
Group A

Introduction. Since delay in recognition and effective treatment of necrotizing fasciitis (NF) caused by invasive group A streptococcus increases the mortality and disability, the early diagnosis and management of this disease are essential for a better outcome. We presented a patient with a severe form of streptococcal NF of the left upper limb in whom amputation was performed as a life saving procedure. Case report. A 65-year-old man, previously healthy, suffered an injury to his left hand by sting on a fish bone. Two days after that the patient got fever, redness, swelling and pain in his left hand. Clinical examination of the patient after admission indicated NF that spread quickly to the entire left upper limb, left armpit, and the left side of the chest and abdomen. Despite the use of aggressive antibiotic and surgical therapy severe destruction of the skin and subcutaneous tissues developed with the development of gangrene of the left upper limb. In this situation, the team of specialists decided that the patient must be operated on submited to amputation of the left arm, at the shoulder. After amputation and aggressive debridement of soft tissue on the left side of the trunk, the patient completely recovered. ?-hemolytic streptococcus group A was isolated from the skin and tissue obtained during the surgery. Conclusion. In the most severe forms of streptococcal NF of the extremities, adequate multidisciplinary treatment, including limb amputation, can save the life of a patient.

scholarly journals Severe Functional Loss of the Hand due to Necrotizing Fasciitis with Underlying Vasculitis Neuropathy

2019 ◽  
Vol 11 (S 01) ◽  
pp. S42-S45
Author(s):  
Tetsushi Aizawa ◽  
Eiko Nakayama ◽  
Satoshi Kubo ◽  
Kazuto Nakamura ◽  
Ryuichi Azuma ◽  
...  
Keyword(s):  
Necrotizing Fasciitis ◽  
Clinical Diagnosis ◽  
Emergency Surgery ◽  
Microscopic Polyangiitis ◽  
High Dose ◽  
Hemolytic Streptococcus ◽  
Streptococcus Group ◽  
Left Hand ◽  
Group A ◽  
Radical Debridement

AbstractA 72-year-old man presented with an erythematous, painful, swollen, and blistering left hand associated with a systemic fever. The patient was diagnosed with microscopic polyangiitis and was receiving steroid therapy from a year before the incident. Based on a clinical diagnosis of necrotizing fasciitis, emergency surgery was performed within 2 days after the onset. β-Hemolytic Streptococcus group A was isolated from a culture of the blood and wound. Radical debridement and high-dose penicillin and clindamycin therapy successfully saved the patient's life and affected limb except for the second finger on his left hand, which was completely necrotic. However, the function of the left hand was seriously decreased and did not recover. The important point to note in this case was the preexisting vasculitis neuropathy due to microscopic polyangiitis. The severe postoperative dysfunction of the hand was considered to be due to ischemic neuropathy that was aggravated by compartmental syndrome and microvascular thrombosis. In conclusion, necrotizing fasciitis of an extremity with underlying vasculitis neuropathy can lead to a poor functional prognosis of the limb.

Necrotizing Fasciitis of the First Ray Caused by Group a Streptococcus

2006 ◽  
Vol 31 (3) ◽  
pp. 317-319 ◽  
Author(s):  
J. LESAFFER ◽  
C. VAN HOLDER ◽  
L. HAECK
Keyword(s):  
Necrotizing Fasciitis ◽  
Upper Limb ◽  
Group A Streptococcus ◽  
Thenar Eminence ◽  
Clinical Entity ◽  
Rare Clinical Entity ◽  
First Ray ◽  
Functional Consequences ◽  
Group A

Necrotizing fasciitis of the hand is a rare clinical entity, frequently with devastating functional consequences. A case of necrotizing fasciitis of the thumb and thenar eminence caused by Group A Streptococcus is reported and the management of this condition in the upper limb discussed.

scholarly journals Group A Streptococci-Associated Necrotizing Fasciitis following Cat Bite in an Immunocompromised Patient

2017 ◽  
Vol 2017 ◽  
pp. 1-3
Author(s):  
Sudheer Nambiar ◽  
Asha Karippot ◽  
Joe Devasahayam ◽  
Tony Oliver
Keyword(s):  
Necrotizing Fasciitis ◽  
Pasteurella Multocida ◽  
Surgical Intervention ◽  
Group A Streptococcus ◽  
Immunocompromised Host ◽  
Tissue Destruction ◽  
Left Hand ◽  
Group A ◽  
Bite Wounds ◽  
High Index Of Suspicion

Necrotizing soft tissue infections are characterized clinically by fulminant tissue destruction, systemic signs of toxicity, and high mortality. Accurate diagnosis and appropriate treatment must include early surgical intervention and antibiotic therapy. Mortality rate is very high and could be even higher in an immunocompromised host. We present a 57-year-old female with history of rheumatoid arthritis on oral corticosteroid and methotrexate therapy with painful swelling of the left hand following a cat bite that was diagnosed as having group A streptococcus pyogenes-associated necrotizing fasciitis. Treatment with ampicillin-sulbactam, Clindamycin, and surgical debridement was performed. In spite of all the adequate therapy she succumbed to death from streptococcal toxic shock and related complications after thirty-two days of treatment in intensive care unit. Necrotizing fasciitis is an uncommon but life-threatening complication in immunocompromised hosts. Tissue infections in cat bite wounds are commonly caused by pathogenic bacterium known as Pasteurella multocida. Group A streptococcal infections are not reported following cat bites. A high index of suspicion must be maintained to suspect group A streptococcal associated necrotizing fasciitis following cat bites and an early medical and surgical intervention should be made for any best possible outcome.

scholarly journals Early Detection of Necrotizing Fasciitis Secondary to Group A Streptococcus: A Case Report

2018 ◽  
Vol 1 (1) ◽  
Author(s):  
Joshua K. Phillips ◽  
Melanie Nukala ◽  
Vandana Grover ◽  
Peter Devito
Keyword(s):  
Case Report ◽  
Early Detection ◽  
Necrotizing Fasciitis ◽  
Group A Streptococcus ◽  
Group A ◽  
Streptococcus A

Magnetic Resonance Imaging in the Early Diagnosis of Group A β Streptococcal Necrotizing Fasciitis: A Case Report

1998 ◽  
Vol 16 (3) ◽  
pp. 403-407 ◽  
Author(s):  
David B Drake ◽  
Julia A Woods ◽  
Timothy J Bill ◽  
Bradley W Kesser ◽  
Mark A Wenger ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Case Report ◽  
Magnetic Resonance ◽  
Early Diagnosis ◽  
Necrotizing Fasciitis ◽  
Resonance Imaging ◽  
Group A

A Case of Necrotizing Fasciitis due to Group G Streptococcus with Amputation Avoided of the Affected Limb

2021 ◽  
Vol 5 (2) ◽  
Author(s):  
Hirayama K ◽  
◽  
Kuroshima T ◽  
Okada M ◽  
Nakayama M ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Necrotizing Fasciitis ◽  
Active Rheumatoid Arthritis ◽  
Early Stage ◽  
Multidisciplinary Treatment ◽  
The Elderly ◽  
Limb Amputation ◽  
Toxic Shock ◽  
Functional Preservation ◽  
Underlying Diseases

Group G Streptococcus (GGS) causes toxic shock syndrome. Its incidence has been increasing in the elderly in recent years. The case is a female patient in her 60s, with rheumatoid arthritis, who developed necrotizing fasciitis in her right thigh. We administered antibacterial agents and debridement frequently at an early stage, followed by aggressive high-protein enteral nutrition and multidisciplinary treatment. During the course of treatment, the patient’s general condition temporarily deteriorated because of fecal contamination. We considered amputation of the lower limb and implantation of a stoma, but finally succeeded in preserving the limb by performing two skin grafts. The patient was able to walk and was discharged on day 66. GGS infection is a risk factor for elderly patients with underlying diseases such as malignancy or immunocompromised states. When necrotizing fasciitis due to fulminant streptococcal infection develops in a proximal limb, amputation of the limb is often necessary to save the patient’s life. In this case, a fulminant GGS infection developed in an immunocompromised patient with active rheumatoid arthritis. Although the risk of limb amputation was high, multidisciplinary treatment enabled functional preservation of the affected limb.

scholarly journals Necrotizing Fasciitis by Two Anaerobic Bacteria in an Immunocompetent Patient after Minor Trauma: A Case Report

2018 ◽  
Vol 2018 ◽  
pp. 1-4
Author(s):  
Marco Sciarra ◽  
Andrea Schimmenti ◽  
Tommaso Manciulli ◽  
Cristina Sarda ◽  
Marco Mussa ◽  
...  
Keyword(s):  
Case Report ◽  
Soft Tissue ◽  
Necrotizing Fasciitis ◽  
Rare Case ◽  
Subcutaneous Tissue ◽  
Anaerobic Bacteria ◽  
Immunocompetent Patient ◽  
Minor Trauma ◽  
Group A Streptococci ◽  
Group A

Necrotizing fasciitis (NF) is a soft tissue infection affecting subcutaneous tissue and the muscular fascia without involvement of the muscle and can be either monomicrobial or polymicrobial. Monomicrobial infections are usually caused by group A streptococci, while infections caused by anaerobic germs usually affect immunodepressed patients. We report a rare case of NF caused by two anaerobic bacteria in an immunocompetent patient.

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