Streptococcal necrotizing fasciitis with toxic shock syndrome following cervical adenitis.
In the recent years an increase of serious invasive infections due to Group A Streptococcus have been reported. Necrotizing fasciitis is a rapidly progressive soft tissue infection characterized by necrosis of the subcutaneous tissues and superficial fascia. We report a case of necrotizing fasciitis and toxic shock syndrome following cervical adenitis in a previously healthy 11-month-old boy. Cultures from blood and the necrotic lymph node grew Group A Streptococcus. Group A Streptococcus belonging to M1 serotype and producing streptococcal pyrogenic exotoxin, SPE A was identified. Full recovery was achieved by aggressive treatment, which included intensive care support, extensive surgical debridement of necrotic lesions and antibiotic treatment with the combination of penicillin and clindamycin.
Department of Otolaryngology, Ha'Emek Medical Center, Afula, Israel. sakran_w@clalit.org.il
Waheeb
W
Sakran
Salim
S
Mazzawi
Yosef
Y
Merzel
Raul
R
Colodner
D019115:Fasciitis, Necrotizing / Q000175:diagnosis / Q000209:etiology* / Q000382:microbiology*; D006801:Humans; D007223:Infant; D008199:Lymphadenitis / Q000000981:diagnostic imaging / Q000209:etiology* / Q000382:microbiology; D008297:Male; D009333:Neck; D012772:Shock, Septic / Q000150:complications*; D013290:Streptococcal Infections / Q000150:complications*; D013297:Streptococcus pyogenes / Q000302:isolation & purification*; D014057:Tomography, X-Ray Computed