Necrotizing Fasciitis Due to Penicillin-resistant Streptococcus pneumoniae

DOI 10 References
  • Takamatsu Junpei
    Department of Emergency and Critical Care Medicine, Kansai Rosai Hospital
  • Ito Takeshi
    Department of Emergency and Critical Care Medicine, Kansai Rosai Hospital
  • Nishimura Tetsurou
    Department of Emergency and Critical Care Medicine, Kansai Rosai Hospital
  • Kishi Masashi
    Department of Emergency and Critical Care Medicine, Kansai Rosai Hospital

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  • ペニシリン耐性肺炎球菌による壊死性筋膜炎の１例

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Abstract

A 67-year-old man with primary macroglobulinemia had noticed the swelling of his lower extremities 3 weeks before the admission to our hospital. As he started to feel pain in his left leg and right flank and ecchymosis started to appear, he consulted a local clinic. On examination, his general condition was so severe that he was transferred to our hospital for the treatment of cellulitis. At the time of admission, blood examinations revealed leukocytopenia and metabolic acidosis. He was considered to be in hypotensive state and was intubated for mechanical ventilation. As the inflammation had already extended to his trunk, we did not conduct a surgery and instead started antibiotics and immunoglobulin therapy. 30 hours after the admission, his condition gradually worsened and he died of septic shock. Histological findings showed massive neutrophilic infiltration in the mediastinum. Penicillin-resistant Streptococcus pneumoniae (PRSP) was isolated from the culture of wound aspirates. Necrotizing fasciitis due to PRSP is quite uncommon. This report discusses necrotizing fasciitis due to penicillin-resistant Streptococcus pneumoniae with reference to primary macroglobulinemia.

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