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.
Cureus
|June 23, 2025
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.
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.
Keywords:
bacterial lymphadenitiscervical lymph nodecervical lymphadenitisgroup a streptococcus pyogeneskikuchi-fujimoto diseasenecrotizing lymphadenitisMore Related Videos
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