Necrotizing Fasciitis and Myositis Caused by Streptococcal Flesh-Eating Bacteria

García-Casares, Elisabet; Soria, L Mateo; García-Melchor, Emma; Alonso, E Riera; Marqués, A Olivé; Pérez, Susana Holgado; Marsà, Xavier Tena; Abós, Sònia Molinos

doi:10.1097/rhu.0b013e3181fe8ba3

Cited by 8 publications

(6 citation statements)

References 17 publications

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“…GAS is also an important cause of post-infectious sequelae such as post-streptococcal glomerulonephritis and rheumatic fever [1], [2], [3], [4]. In contrast, Moraxella catarrhalis is a rather exclusive colonizer and primarily opportunistic pathogen of the human respiratory tract, the bacterium being associated with both upper (e.g.…”

Section: Introductionmentioning

confidence: 99%

Differential Virulence Gene Expression of Group A Streptococcus Serotype M3 in Response to Co-Culture with Moraxella catarrhalis

et al. 2013

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Streptococcus pyogenes (group A Streptococcus, GAS) and Moraxella catarrhalis are important colonizers and (opportunistic) pathogens of the human respiratory tract. However, current knowledge regarding colonization and pathogenic potential of these two pathogens is based on work involving single bacterial species, even though the interplay between respiratory bacterial species is increasingly important in niche occupation and the development of disease. Therefore, to further define and understand polymicrobial species interactions, we investigated whether gene expression (and hence virulence potential) of GAS would be affected upon co-culture with M. catarrhalis. For co-culture experiments, GAS and M. catarrhalis were cultured in Todd-Hewitt broth supplemented with 0.2% yeast extract (THY) at 37°C with 5% CO2 aeration. Each strain was grown in triplicate so that triplicate experiments could be performed. Bacterial RNA was isolated, cDNA synthesized, and microarray transcriptome expression analysis performed. We observed significantly increased (≥4-fold) expression for genes playing a role in GAS virulence such as hyaluronan synthase (hasA), streptococcal mitogenic exotoxin Z (smeZ) and IgG endopeptidase (ideS). In contrast, significantly decreased (≥4-fold) expression was observed in genes involved in energy metabolism and in 12 conserved GAS two-component regulatory systems. This study provides the first evidence that M. catarrhalis increases GAS virulence gene expression during co-culture, and again shows the importance of polymicrobial infections in directing bacterial virulence.

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Section: Introductionmentioning

confidence: 99%

Differential Virulence Gene Expression of Group A Streptococcus Serotype M3 in Response to Co-Culture with Moraxella catarrhalis

et al. 2013

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“…al. who reported that 2 out of 3 cases of necrotizing fasciitis did not have any risk factors for the condition [14]. Necrotizing fasciitis is classified according to its microbiology i.e.…”

Section: Discussionmentioning

confidence: 99%

Septic Arthritis of the Knee and Necrotizing Fasciitis in a Young Immunocompetent Adult: A Case Report

Miptah¹,

Badlishah-Sham²,

LLyod³

et al. 2018

JCHS

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Septic arthritis is uncommon in immunocompetent young adults. It typically presents in individuals with underlying risk factors. Isolation of Group A Streptococcus (GAS) as the causative agent of septic arthritis is usually associated with autoimmune diseases, chronic skin infections or trauma. Here we report a case of a young lady who is immunocompetent without any prior history of trauma, who presented with an abrupt onset of left knee pain and swelling to the emergency department. An initial diagnosis of acute gout was made and she was treated with non-steroidal anti-inflammatory drug (NSAID). She presented again two days later to a primary care clinic with worsening knee pain and severe left calf pain. A clinical diagnosis of septic arthritis was suspected and the patient was urgently referred to the Orthopaedic team. Synovial fluid from the knee joint aspiration showed growth of GAS. A diagnosis of necrotizing fasciitis was also made as the culture taken from the left calf during incision and drainage (I&D) procedure showed a mixed growth. She eventually underwent surgical debridement twice, together with the administration of several courses of intravenous antibiotics leading to her full recovery after 45 days. This case demonstrates the challenge in making a prompt diagnosis of septic arthritis and probable Type II necrotizing fasciitis in an immunocompetent adult without underlying risk factors. Any delay in diagnosis and treatment would have increased the risk of damage to her knee joint and this may be fatal even in a previously healthy young adult. KEYWORDS: septic arthritis, immunocompetent, Group A streptococcus, necrotizing fasciitis

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“…In SOTRs, streptococcal species are associated with causing a variety of skin infections, such as impetigo contagiosa [5], ecthyma, and NF [33]. Streptococcus pyogenes is the most common pathogen to cause monomicrobial NF [17], though Streptococcus pneumoniae has also caused disease in renal transplant recipients [34].…”

Section: Cutaneous Streptococcal Infectionsmentioning

confidence: 99%

Skin Infections due to Bacteria in Solid Organ Transplant Recipients: A Review

Ilyas¹,

Maganty²,

Ginsberg³

et al. 2017

Dermatology

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Though there is an abundance of information on cutaneous malignancies in transplant recipients, cutaneous infections in solid organ transplant recipients (SOTRs) are underrepresented in the dermatological literature. Our paper provides a comprehensive review of bacterial cutaneous infections within the solid organ transplant population. Cutaneous bacterial infections may lead to significant morbidity and even mortality in this immunosuppressed population. Thus, it is to the benefit of both dermatologists and other transplant care providers to better understand and recognize the features of cutaneous bacterial infections in SOTRs. This paper can aid providers in promptly identifying, diagnosing, and treating bacterial skin infections. This review discusses the diagnosis and treatment of the following bacterial species: Staphylococcus, Streptococcus, Pseudomonas aeruginosa, Escherichia coli, Nocardia, Mycobacteria, and Bartonella henselae.

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Necrotizing Fasciitis and Myositis Caused by Streptococcal Flesh-Eating Bacteria

Cited by 8 publications

References 17 publications

Differential Virulence Gene Expression of Group A Streptococcus Serotype M3 in Response to Co-Culture with Moraxella catarrhalis

Differential Virulence Gene Expression of Group A Streptococcus Serotype M3 in Response to Co-Culture with Moraxella catarrhalis

Septic Arthritis of the Knee and Necrotizing Fasciitis in a Young Immunocompetent Adult: A Case Report

Skin Infections due to Bacteria in Solid Organ Transplant Recipients: A Review

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