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Group B Streptococcal Cellulitis and Necrotizing Fasciitis in Infants: A Systematic Review

Monika Wojtera1, Horace Cheng2,3, Kyle Fiorini1,3

  • 1From the Schulich School of Medicine and Dentistry.

The Pediatric Infectious Disease Journal
|February 10, 2018
PubMed

Insights

Group B Streptococcus (GBS) head and neck infections in infants, including cellulitis and necrotizing fasciitis, lack a clear treatment consensus. Conservative antibiotic treatment can be effective, but severe cases may require surgical debridement.

Area of Science:

  • Neonatal infections
  • Pediatric infectious diseases
  • Microbiology

Background:

  • Group B Streptococcus (GBS) can cause severe skin and soft tissue infections in infants.
  • There is a lack of established guidelines for managing infantile GBS head and neck cellulitis and necrotizing fasciitis.

Observation:

  • A case of GBS facial necrotizing fasciitis in a 33-day-old infant was successfully managed with antibiotics alone.
  • A literature review identified 40 infants with GBS head and neck cellulitis, predominantly late-onset, male, and premature.
  • Twelve cases of GBS necrotizing fasciitis were identified, often polymicrobial, with 75% requiring debridement.

Findings:

  • Penicillin is the primary antibiotic for GBS head and neck cellulitis (97% of cases).
  • Necrotizing fasciitis cases frequently involved polymicrobial infections and broad-spectrum antibiotics.
  • Head and neck necrotizing fasciitis had an 80% rate of requiring surgical debridement.

Implications:

  • Early recognition and prompt antibiotic therapy are crucial for infantile GBS skin and soft tissue infections.
  • Surgical debridement should be considered for severe necrotizing fasciitis cases.
  • Further research is needed to establish optimal management strategies for these rare but serious infections.
Abstract

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