[Fulminant streptococcal gangrene of the lower limbs].
A 58 year old woman with Cushing's disease was admitted to hospital for acute ischaemia of the lower limbs due to fulminant streptococcal gangrene (necrosing fasciitis). A group A beta-haemolytic Streptococcus was isolated from the cutaneous lesions and the blood cultures. Despite antibiotic therapy and medical resuscitation, the patient died within 12 hours of her admission in a state of irreversible collapse. This gangrenous cellulitis, in which a hypersensitivity reaction plays a part in the pathophysiology, is a rare disease which is fatal in one half of cases. The diagnosis is based on a very marked alteration in the general state, the characteristics of the cutaneous lesions and, most importantly, the isolation of group A haemolytic Streptococci, which should be performed early so as to allow wide surgical excision, which remains the principal therapeutic measure, as rapidly as possible.
D003480:Cushing Syndrome / Q000150:complications*; D005260:Female; D005734:Gangrene; D006801:Humans; D007511:Ischemia / Q000209:etiology; D007866:Leg / Q000098:blood supply* / Q000473:pathology; D008875:Middle Aged; D013290:Streptococcal Infections / Q000209:etiology*; D013297:Streptococcus pyogenes
Gangrène streptococcique fulminante des membres inférieurs.