title: Streptococcus pneumoniae necrotizing fasciitis in systemic lupus erythematosus.
abstract: Necrotizing fasciitis is a rapidly progressive destructive soft tissue infection with high mortality. Streptococcus pneumoniae as etiologic agent of necrotizing fasciitis is extremely unusual. The increased susceptibility to Streptococcus pneumoniae infection in patients with systemic lupus erythematosus is probably a multifactorial phenomenon. We report a case of a patient, a 36-year-old Caucasian female with 8-year history of systemic lupus erythematosus who presented a fatal Streptococcus pneumoniae necrotizing fasciitis. The role of computed tomography and the high performance of blood cultures for isolation of the causative microorganism are emphasized. Once diagnosis is suspected, empiric antibiotic treatment must be prescribed and prompt surgical exploration is mandatory.
authors.affiliation: Unidad de Enfermedades Autoinmunes Sistémicas, Clínica Médica "C", Prof. Dr. Juan Alonso Bao, Hospital de Clínicas, Facultad de Medicina, Universidad de la República, Montevideo, Uruguay.
authors.forename: A
authors.initials: A
authors.lastname: Sánchez
authors.affiliation: Unidad de Enfermedades Autoinmunes Sistémicas, Clínica Médica "C", Prof. Dr. Juan Alonso Bao, Hospital de Clínicas, Facultad de Medicina, Universidad de la República, Montevideo, Uruguay.
authors.forename: R
authors.initials: R
authors.lastname: Robaina
authors.affiliation: Unidad de Enfermedades Autoinmunes Sistémicas, Clínica Médica "C", Prof. Dr. Juan Alonso Bao, Hospital de Clínicas, Facultad de Medicina, Universidad de la República, Montevideo, Uruguay.
authors.forename: G
authors.initials: G
authors.lastname: Pérez
authors.affiliation: Unidad de Enfermedades Autoinmunes Sistémicas, Clínica Médica "C", Prof. Dr. Juan Alonso Bao, Hospital de Clínicas, Facultad de Medicina, Universidad de la República, Montevideo, Uruguay ecairoli@hc.edu.uy.
authors.forename: E
authors.initials: E
authors.lastname: Cairoli
mesh_terms: D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001431:Bacteriological Techniques; D019115:Fasciitis, Necrotizing / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology*; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D016867:Immunocompromised Host; D007166:Immunosuppressive Agents / Q000009:adverse effects; D008180:Lupus Erythematosus, Systemic / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy / Q000276:immunology; D009894:Opportunistic Infections / Q000175:diagnosis / Q000188:drug therapy / Q000276:immunology / Q000382:microbiology*; D011008:Pneumococcal Infections / Q000175:diagnosis / Q000188:drug therapy / Q000276:immunology / Q000382:microbiology*; D011237:Predictive Value of Tests; D013296:Streptococcus pneumoniae / Q000187:drug effects / Q000276:immunology / Q000302:isolation & purification*; D014057:Tomography, X-Ray Computed
chemical_list: D000900:Anti-Bacterial Agents; D007166:Immunosuppressive Agents
keywords: Streptococcus pneumoniae; infection; necrotizing fasciitis; systemic lupus erythematosus