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Journal of the American Podiatric Medical Association, Vol 89, Issue 9 454-457, Copyright © 1999 by American Podiatric Medical Association

JOURNAL ARTICLE

The increased prevalence of severe necrotizing infections caused by non-group A streptococci

AM Reyzelman, BA Lipsky, SA Hadi, LB Harkless and DG Armstrong
Pacific Coast Wound Care, California College of Podiatric Medicine, San Francisco, USA.

The authors report on 20 patients who were admitted to the University of Texas Health Science Center at San Antonio during a recent 4-month period with foot infections caused predominantly by non-group A streptococci. This number of patients was significantly greater than the number admitted to the same institution with the same diagnosis during the preceding 3 years. All patients had type 2 diabetes mellitus. In each case, a rapidly spreading cellulitis followed trauma to the foot, which necessitated emergent incision and drainage. Five patients required extensive fascial and skin debridement because of soft-tissue destruction, and two patients needed below-the-knee amputation because of uncontrolled infection. These cases suggest that non-group A streptococci, like group A streptococci, can cause serious skin and soft-tissue infections in patients with diabetes that may require aggressive surgical debridement despite appropriate antibiotic therapy.




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Copyright © 1999 by the American Podiatric Medical Association.