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Case Report of Necrotizing Fasciitis Associated with Streptococcus pneumoniae

Lei Jiao1, Zain Chagla2, Reham Mohammedsaeed Kaki3

  • 1Medical Microbiology Postgraduate Training Program, Pathology and Molecular Medicine, McMaster University, Hamilton, ON, Canada L8S 4L8.

The Canadian Journal of Infectious Diseases & Medical Microbiology = Journal Canadien Des Maladies Infectieuses Et De La Microbiologie Medicale
|July 2, 2016
PubMed

Insights

This case report details an extremely rare instance of early necrotizing fasciitis caused by Streptococcus pneumoniae in an immunocompromised patient. Prompt diagnosis allowed for successful treatment without extensive surgical intervention.

Area of Science:

  • Infectious Diseases
  • Bacteriology
  • Dermatology

Background:

  • Necrotizing fasciitis is a severe soft tissue infection, typically caused by Group A Streptococcus.
  • Streptococcus pneumoniae is a common pathogen, but rarely associated with necrotizing fasciitis.
  • Immunocompromised individuals with connective tissue diseases are at higher risk for severe infections.

Purpose of the Study:

  • To report the first known case of early-phase necrotizing fasciitis caused by Streptococcus pneumoniae.
  • To highlight the successful management of this rare condition without surgical debridement.
  • To emphasize the importance of considering unusual pathogens in immunocompromised patients.

Main Methods:

  • Case report of a 26-year-old immunocompromised male with mixed connective tissue disease.
  • Clinical presentation of rapidly progressing erythematous and edematous skin lesions.
  • Diagnostic confirmation through pathological examination of tissue biopsies and positive bacterial cultures (Streptococcus pneumoniae) from fascial and blood samples.

Main Results:

  • Diagnosis of necrotizing fasciitis confirmed by fascia necrosis and neutrophil infiltration.
  • Isolation of Streptococcus pneumoniae from fascial tissue and blood cultures.
  • Successful recovery of the patient without the need for surgical debridement due to early diagnosis and treatment.

Conclusions:

  • Streptococcus pneumoniae can cause early-phase necrotizing fasciitis, even in immunocompromised patients.
  • Early diagnosis and appropriate management can lead to favorable outcomes, potentially avoiding extensive surgery.
  • This case expands the spectrum of pathogens associated with necrotizing fasciitis and underscores the need for vigilant diagnosis in at-risk populations.

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