title: Necrotizing fasciitis caused by Staphylococcus aureus.
abstract: Two patients with rapidly progressive necrotizing fasciitis of a lower extremity due to Staphylococcus aureus as a single pathogen are described. In both patients the portal of entry was attributed to needle puncture (intra-articular injection and intravenous catheter, respectively), followed by bacteremia. Necrotizing fasciitis occurred in a site remote from the needle puncture, suggesting metastatic infection. One patient developed toxic shock syndrome and the other a sunburn-like rash and erythematous mucosae with strawberry tongue. One patient died, and the other required above-knee amputation due to secondary infectious complications. Staphylococcus aureus may mimic the presentation of invasive group A streptococcal infections. A history of needle puncture should alert the physician to the possibility of Staphylococcus aureus infection.
authors.affiliation: Department of Internal Medicine E, Rabin Medical Center, Petach-Tikvah, Israel.
authors.forename: A
authors.initials: A
authors.lastname: Regev
authors.forename: M
authors.initials: M
authors.lastname: Weinberger
authors.forename: M
authors.initials: M
authors.lastname: Fishman
authors.forename: Z
authors.initials: Z
authors.lastname: Samra
authors.forename: S D
authors.initials: SD
authors.lastname: Pitlik
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D016470:Bacteremia / Q000382:microbiology; D002406:Catheterization, Peripheral; D004866:Equipment Contamination; D019115:Fasciitis, Necrotizing / Q000175:diagnosis / Q000382:microbiology*; D005260:Female; D006801:Humans; D007270:Injections, Intra-Articular; D008875:Middle Aged; D009339:Needles / Q000382:microbiology; D013203:Staphylococcal Infections / Q000382:microbiology* / Q000635:transmission; D013211:Staphylococcus aureus / Q000302:isolation & purification*