Necrotizing fasciitis due to penicillin-resistant Streptococcus pneumoniae: case report and review of the literature.

Abstract

Necrotizing fasciitis (NF) is a life-threatening infection involving rapid necrosis of subcutaneous and fascial tissues. Streptococcus pneumoniae (SPN) soft tissue infection is exceedingly uncommon, reported primarily in patients with immunosuppression or other underlying conditions. We report a case of NF and septic shock in a healthy 32-year-old man, whose only predisposing factor was antecedent blunt trauma. Pathological examination and culture of the extensive tissue debridement were positive only for SPN. The serotype 9V isolate was penicillin (PCN)-resistant (MIC=2.0), and closely-related by pulse field gel electrophoresis and multilocus fingerprinting to clone France 9V-3, an important genetic reservoir for increasing PCN-resistance worldwide. This unique case has implications for our pathogenic under-standing and empiric management of NF.

• Authors: G R Ballon-Landa, G Gherardi, B Beall, S Krosner, V Nizet
• Journal: The Journal of infection (J Infect) Vol. 42 Issue 4 Pg. 272-7 (May 2001) ISSN: 0163-4453 [Print] England
• PMID: 11545571 (Publication Type: Case Reports, Journal Article, Review)
• Copyright: Copyright 2001 The British Infection Society.

Chemical References

• Anti-Bacterial Agents

Topics

• Adult
• Anti-Bacterial Agents
• Drug Therapy, Combination (therapeutic use)
• Electrophoresis, Gel, Pulsed-Field
• Fasciitis, Necrotizing (diagnosis, microbiology, pathology, therapy)
• Humans
• Immunocompetence
• Male
• Penicillin Resistance
• Shock, Septic (microbiology)
• Streptococcus pneumoniae (drug effects, genetics, isolation & purification)
• Wounds, Nonpenetrating (complications)