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Case Reports
. 2008 Jan;19(1):69-71.
doi: 10.1155/2008/246468.

A case of necrotizing fasciitis due to Streptococcus pneumoniae serotype 5 in Saskatchewan

Meenakshi Dawar  1 , Bob Russell, Karen McClean, Paul N Levett, Gregory J Tyrrell, James Irvine
Affiliations
Case Reports

A case of necrotizing fasciitis due to Streptococcus pneumoniae serotype 5 in Saskatchewan

Meenakshi Dawar et al. Can J Infect Dis Med Microbiol. 2008 Jan.

Abstract
in English, French

Necrotizing fasciitis due to Streptococcus pneumoniae is a rare and grave condition, and only a few cases have been reported. Suggested risk factors include minor trauma, systemic lupus erythematosus, immunosuppression secondary to medication, use of intramuscular anti-inflammatories and alcoholism. A fatal case of pneumococcal necrotizing fasciitis that occurred in a 51-year-old woman with a history of alcohol abuse and oral anti-inflammatory use is presented. Her condition was caused by a multi-etiology outbreak of community-acquired pneumonia, from which S pneumoniae serotype 5 was also isolated. The case description outlines the subtle presentation and rapid clinical progression of this condition. Because serotype 5 antigen is included in the polysaccharide 23-valent pneumococcal vaccine, the present case highlights the importance of pneumococcal immunization programs in Canada.

La fasciite nécrosante à Streptococcus pneumoniæ est une maladie grave et rare dont quelques cas seulement ont été signalés. Les facteurs de risque possibles incluent : traumatismes mineurs, lupus érythémateux disséminé, immunosuppression d’origine médicamenteuse, prise d’anti-inflammatoires intramusculaires et alcoolisme. On présente ici un cas fatal de fasciite nécrosante pneumococcique chez une femme de 51 ans qui avait des antécédents d’éthylisme et qui était traitée au moyen d’anti-inflammatoires. Sa maladie a été causée par une éclosion multi-étiologique de pneumonie d’origine communautaire où l’on a isolé le sérotype 5 de S. pneumoniæ. La description de ce cas met en lumière les subtilités du tableau clinique et la progression rapide de cette maladie. Étant donné que l’antigène du sérotype 5 est inclus dans le vaccin antipneumococcique polysaccharidique 23-valent, le présent cas rappelle l’importance des programmes d’immunisation antipneumococcique au Canada.

Keywords: Aboriginal; Canada; Necrotizing fasciitis; Streptococcus pneumoniae.

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Figures

Figure 1
Figure 1
Portable chest x-ray of a 51-year-old woman presenting with necrotizing fasciitis, toxic shock syndrome and community-acquired pneumonia in the absence of respiratory symptoms. Figure by Dr Ben Tan, Division of Infectious Diseases, Royal University Hospital, Saskatoon, Saskatchewan
See this image and copyright information in PMC

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