[Secondary Streptococcus pyogenes peritonitis following necrotizing fasciitis]

Ann Fr Anesth Reanim. 2004 Jul;23(7):737-9. doi: 10.1016/j.annfar.2004.02.054.
[Article in French]

Abstract

We report the case of a 66-year-old woman with diabetes mellitus and disseminated lupus treated with immunosupressive drug. She was admitted for an inflammatory oedema of the right lower limb associated to diffuse abdominal pain and vomiting. The occurrence of septic shock with multiple organ failure and surgical abdominal picture led us to perform urgent laparotomy without taking in account the evolutive signs of cutaneous lesions i.e. purpuric elements and haemorrhagic phlycthena. The abdominal cavity exploration showed peritonitis without digestive tracts perforation. The patient died few hours after surgical procedure. All bacteriological samples i.e. peritoneal effusion, blood cultures and phlycthena liquid were positive for Streptocoque pyogenes (group A) and peritonitis was considered to be related to haematogen diffusion from rapid course necrotizing fasciitis.

Publication types

  • Case Reports
  • English Abstract

MeSH terms

  • Aged
  • Diabetes Mellitus, Type 2 / complications
  • Fasciitis, Necrotizing / complications*
  • Fasciitis, Necrotizing / microbiology
  • Fatal Outcome
  • Female
  • Humans
  • Laparotomy
  • Lupus Erythematosus, Systemic
  • Multiple Organ Failure / complications
  • Purpura / complications
  • Shock, Septic / complications
  • Streptococcal Infections / etiology*
  • Streptococcal Infections / microbiology
  • Streptococcus pyogenes*