Nonclostridial gas gangrene due to Streptococcus anginosus in a diabetic patient

Shimizu, Takahiro; Harada, Mikihiko; Zempo, Nobuya; Sadamitsu, Daikai; Furumoto, Hideyuki; Uchida, Hiroshi; Yasui, Hiro; Ofuji, Reiko; Muto, Masahiko

doi:10.1016/s0190-9622(99)70483-4

Cited by 11 publications

(2 citation statements)

References 13 publications

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“…8,12,20 For example, SMG infections have been identified in the liver, oral cavity, intracranium, appendix, peritoneum, pleural space, meninges, skin, muscle, and lung. 8–12–17,19–21 Epidemiologic data from the Calgary Health Region estimated the incidence of hospitalization from SMG species infections at 8.65 per 100,000 patients between July 1999 to June 2004. This group found soft-tissue infections to be one of the most common anatomic sites for SMG infections, comprising 15% of SMG-infections identified.…”

Section: Discussionmentioning

confidence: 99%

“…For example, a 62-year-old insulin-dependent diabetic woman with poor glucose control experienced a severe SMG-associated infection resulting in nonclostridial gas gangrene of the perineal area. 13 As another example, a 72-year-old diabetic woman was infected with SMG in the skull; mastoiditis ensued and developed into a Bezold's abscess. 14 A study considering 281 diabetic patients in Australia admitted for bacteremia found 1 patient to be infected with SMG 15 In an investigation conducted in Israel, 30 of the 245 patients hospitalized for SMG infections had diabetes.…”

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confidence: 99%

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Streptococcus milleri Group Cutaneous Abscess Associated with Insulin Injection to Distal Lower Extremity in an Insulin-Dependent Diabetic Man

Kerr

Fugit²

2012

Hosp Pharm

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Purpose We report a case of Streptococcus milleri group (SMG)-associated cutaneous abscess in an older diabetic man. The infection developed after subcutaneous insulin injection to the distal lower extremity. This is the first known account of SMG-associated abscess secondary to insulin administration. Summary A 60-year-old Caucasian insulin-dependent diabetic male developed a severe cutaneous infection including abscess and surrounding cellulitis at the site of a self-administered insulin glargine injection on the medial portion of his right lower leg. The infection developed rapidly within 1 day following the injection. Cultures from purulent drainage were positive for SMG. The infection resolved rapidly with an antibiotic regimen including 1 dose of clindamycin followed by intravenous pipercillin/tazobactam plus vancomycin and concluded with outpatient treatment with sulfamethoxazole/trimethoprim. Organisms belonging to SMG are increasingly recognized as pyogenic pathogens responsible, most commonly, for abscess infections. SMG infections have been reported in diabetics; however, this is the first known case of SMG-associated abscess secondary to subcutaneous insulin administration. Conclusion A 60-year-old diabetic male experienced a severe SMG-associated abscess in the distal lower extremity after self-injection with insulin glargine. The infection resolved rapidly with intravenous and oral antibiotics. Clinicians should be aware of the potential for abscess infection from SMG at insulin injection sites.

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Streptococcus milleri Group Cutaneous Abscess Associated with Insulin Injection to Distal Lower Extremity in an Insulin-Dependent Diabetic Man

Kerr

Fugit²

2012

Hosp Pharm

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A woman with fever and back pain

Ono

Kitagawa

2021

JACEP Open

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An 89-year-old female with a history of untreated diabetes mellitus presented with a 1-month history of fever and back pain. Four months prior, she had a dental extraction. On arrival, her temperature was 38.5 • C, blood pressure 108/56 mmHg, pulse 114 beats/min, and oxygen saturation 92% while breathing ambient air. Physical examination showed percussion tenderness of thoracic vertebrae. Lab-F I G U R E 1 Computed tomography scan revealing intraosseous gas (red arrows) and emphysematous lesions around the spine (white arrows) at the thoracic level. (Left; axial view, right; sagittal view.) This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.

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Bacterial and rickettsial infections

Weedon

2010

Weedon's Skin Pathology

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Nonclostridial gas gangrene due to Streptococcus anginosus in a diabetic patient

Cited by 11 publications

References 13 publications

Streptococcus milleri Group Cutaneous Abscess Associated with Insulin Injection to Distal Lower Extremity in an Insulin-Dependent Diabetic Man

Streptococcus milleri Group Cutaneous Abscess Associated with Insulin Injection to Distal Lower Extremity in an Insulin-Dependent Diabetic Man

A woman with fever and back pain

Bacterial and rickettsial infections

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