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Case Reports
. 2018 Jun 22;18(1):198.
doi: 10.1186/s12887-018-1177-9.

A case report of hemolytic streptococcal gangrene in the danger triangle of the face with thrombocytopenia and hepatitis

Xiao-Ling Jia  1 , Janak L Pathak  2 , Jin-Fa Tong  1 , Ji-Mei Su  3
Affiliations
Case Reports

A case report of hemolytic streptococcal gangrene in the danger triangle of the face with thrombocytopenia and hepatitis

Xiao-Ling Jia et al. BMC Pediatr. .

Abstract

Background: Hemolytic streptococcus gangrene is a life threatening invasive bacterial infection. Hemolytic streptococcus gangrene in the danger triangle of the face is too lethal to operate. A case of the confirmed hemolytic streptococcus gangrene in the danger triangle of the face caused by Group A beta-hemolytic streptococcus (GAS) in 20-months old boy is presented to draw attention of clinicians to this uncommon but frequently fatal infection.

Case presentation: Previously healthy 20 months old boy suddenly developed paranasal gangrene on the left side of the danger triangle of the face, followed by rapidly progressive thrombocytopenia and hepatitis. The clinical features, liver function, and hematological and serological parameters resembled to a description of streptococcal toxic shock syndrome (STSS). Aggressive antibiotics, substitutional and supportive therapy were conducted without surgical debridement of facial tissues. Prompt diagnosis and aggressive timely treatment completely cured the disease in 28 days.

Conclusions: The present case report demonstrates prompt diagnosis and timely treatment as a strategy to cure the fatal hemolytic streptococcus gangrene located in too risky body part to operate.

Keywords: Group-a beta-hemolytic streptococcus; Hemolytic streptococcus gangrene; Hepatitis; The danger triangle of the face; Thrombocytopenia.

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Conflict of interest statement

Ethics approval and consent to participate

This study was approved by the Ethical committee for clinical research of Zhejiang University School of Medicine, Hangzhou, China. Written informed consent to participate in this case study was obtained form the patients’ parents according to the provisions of the Declaration of Helsinki.

Consent for publication

Written informed consent for publication this case report and accompanying images were obtained from the patients’ parents. Copies of the signed informed consent form are available for review by the Series Editor of BMC Pediatrics.

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Image of hemolytic streptococcus gangrene in the left maxillofacial region upon admission
Fig. 2
Fig. 2
Image of hemolytic streptococcus gangrene in the left maxillofacial region after 7 days of admission
See this image and copyright information in PMC

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