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Case Report of Necrotizing Fasciitis Associated with Streptococcus pneumoniae


Affiliations
1 Medical Microbiology Postgraduate Training Program, Pathology and Molecular Medicine, McMaster University, Hamilton, ON, L8S 4L8, Canada
2 St. Joseph Healthcare and Hamilton Health Sciences, Hamilton, ON, L8N 1Y2, Canada
3 Department of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
4 Department of Pathology and Molecular Medicine, McMaster University, Hamilton, ON, L8S 4L8, Canada
 

Necrotizing fasciitis, caused by Streptococcus pneumoniae, is an extremely rare and life-threatening bacterial soft tissue infection. We report a case of early necrotizing fasciitis associated with Streptococcus pneumoniae infection in a 26-year-old man who was immunocompromised with mixed connective tissue disease. The patient presented with acute, painful, erythematous, and edematous skin lesions of his right lower back, which rapidly progressed to the right knee. The patient underwent surgical exploration, and a diagnosis of necrotizing fasciitis was confirmed by pathological evidence of necrosis of the fascia and neutrophil infiltration in tissue biopsies. Cultures of fascial tissue biopsies and blood samples were positive for Streptococcus pneumoniae. To our knowledge, this is the first report of necrotizing fasciitis resulting from Streptococcus pneumoniae diagnosed at early phase; the patient recovered well without surgical debridement.
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  • Case Report of Necrotizing Fasciitis Associated with Streptococcus pneumoniae

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Authors

Lei Jiao
Medical Microbiology Postgraduate Training Program, Pathology and Molecular Medicine, McMaster University, Hamilton, ON, L8S 4L8, Canada
Zain Chagla
St. Joseph Healthcare and Hamilton Health Sciences, Hamilton, ON, L8N 1Y2, Canada
Reham Mohammedsaeed Kaki
Department of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
Gabriela Gohla
Department of Pathology and Molecular Medicine, McMaster University, Hamilton, ON, L8S 4L8, Canada
Marek Smieja
Department of Pathology and Molecular Medicine, McMaster University, Hamilton, ON, L8S 4L8, Canada

Abstract


Necrotizing fasciitis, caused by Streptococcus pneumoniae, is an extremely rare and life-threatening bacterial soft tissue infection. We report a case of early necrotizing fasciitis associated with Streptococcus pneumoniae infection in a 26-year-old man who was immunocompromised with mixed connective tissue disease. The patient presented with acute, painful, erythematous, and edematous skin lesions of his right lower back, which rapidly progressed to the right knee. The patient underwent surgical exploration, and a diagnosis of necrotizing fasciitis was confirmed by pathological evidence of necrosis of the fascia and neutrophil infiltration in tissue biopsies. Cultures of fascial tissue biopsies and blood samples were positive for Streptococcus pneumoniae. To our knowledge, this is the first report of necrotizing fasciitis resulting from Streptococcus pneumoniae diagnosed at early phase; the patient recovered well without surgical debridement.