title: Systemic lupus erythematosus developing immediately after necrotizing fasciitis.
abstract: Necrotizing fasciitis (NF) is a medical-surgical emergency characterized by severe bacterial infection that affects the subcutaneous tissue and spreads to the underlying fascia; usually it is caused by penetrating trauma, sometimes by surgical therapy, very rarely by minor insults such as insect bites. Systemic lupus erythematosus (SLE) is a potentially fatal autoimmune disease involving virtually all the key components of the immune system. Although cases of post-infection autoimmunity were already described, a literature search using Pub Med and Medline revealed that SLE was never reported to occur in patients affected, immediately before, with NF. We observed and herein report, however, a case of a woman showing an insect-bite-induced NF, which was immediately followed by the development of a SLE. In conclusion, this case of postinfection autoimmunity provides early evidence of a patient developing SLE immediately after NF, and suggests that caution in the follow-up of NF is necessary, because NF might favor the development of a severe autoimmunity.
authors.affiliation: Section of Dermatology, Department of Surgical Sciences, Parma University, Parma, Italy.
authors.forename: S
authors.initials: S
authors.lastname: Santoro
authors.forename: C
authors.initials: C
authors.lastname: Cortelazzi
authors.forename: M
authors.initials: M
authors.lastname: Santini
authors.forename: D
authors.initials: D
authors.lastname: Santilli
authors.forename: C A
authors.initials: CA
authors.lastname: Pepe
authors.forename: S
authors.initials: S
authors.lastname: Castagnetti
authors.forename: F
authors.initials: F
authors.lastname: Zambito-Spadaro
authors.forename: G
authors.initials: G
authors.lastname: De Panfilis
authors.forename: G
authors.initials: G
authors.lastname: Fabrizi
mesh_terms: D000328:Adult; D019115:Fasciitis, Necrotizing / Q000150:complications*; D005260:Female; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000209:etiology*; D013997:Time Factors