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Pyelonephritis is a bacterial infection that primarily affects the renal parenchyma and collecting system, including the renal pelvis, tubules, and interstitial tissue of one or both kidneys. It can be classified as either acute—a sudden, severe infection—or chronic, which refers to long-term or recurrent kidney infections.The primary cause of acute pyelonephritis (APN) is bacterial infection, with Escherichia coli accounting for approximately 70-80% of cases. Other bacteria, such...
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A Case of Necrotizing Lymphadenitis From Streptococcus pyogenes.

Brittani P Kongala1, David J Gorelov1, Anwar A Khan1

  • 1Medicine, Florida State University College of Medicine, Tallahassee, USA.

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|June 23, 2025
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Summary

Necrotizing lymphadenitis (NL) is a rare condition. This case highlights an unusual bacterial cause, Streptococcus pyogenes, emphasizing the need to consider bacterial infections in NL diagnosis.

Keywords:
bacterial lymphadenitiscervical lymph nodecervical lymphadenitisgroup a streptococcus pyogeneskikuchi-fujimoto diseasenecrotizing lymphadenitis

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Area of Science:

  • Infectious Diseases
  • Pathology

Background:

  • Necrotizing lymphadenitis (NL) is a rare condition characterized by necrotic, non-granulomatous lymphadenopathy.
  • While often idiopathic, autoimmune, or viral, bacterial causes of NL are exceptionally uncommon.

Observation:

  • A 25-year-old female presented with sepsis, fever, and neck pain due to an enlarged cervical lymph node.
  • Despite antibiotic treatment, the lymph node grew, leading to ultrasound-guided aspiration revealing purulent fluid and necrosis.

Findings:

  • The patient was diagnosed with necrotizing lymphadenitis secondary to Streptococcus pyogenes infection.
  • Literature review identified only one prior case of NL attributed to S. pyogenes.

Implications:

  • This case underscores the importance of considering bacterial etiologies, specifically Streptococcus pyogenes, in the differential diagnosis of necrotizing lymphadenitis.
  • The findings highlight the diagnostic and therapeutic challenges associated with this rare presentation of bacterial lymphadenitis.