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Necrotizing fasciitis and meningitis due to Streptococcus pneumoniae serotype 9 N: a case report

BACKGROUND: Necrotizing fasciitis is a deep infection of the fascia and subcutaneous tissue with a high mortality rate. Meningitis is an infection of the membranes surrounding the brain with a likewise high mortality rate. Streptococcus pneumoniae is the most frequent cause of bacterial meningitis a...

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Autores principales: Hovmand, Nichlas, Byberg, Sarah, Larsen, Morten Bo, Podlekareva, Daria, Buck, David Levarett, Hansen, Birgitte Rønde
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6489194/
https://www.ncbi.nlm.nih.gov/pubmed/31035964
http://dx.doi.org/10.1186/s12879-019-3969-4
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author Hovmand, Nichlas
Byberg, Sarah
Larsen, Morten Bo
Podlekareva, Daria
Buck, David Levarett
Hansen, Birgitte Rønde
author_facet Hovmand, Nichlas
Byberg, Sarah
Larsen, Morten Bo
Podlekareva, Daria
Buck, David Levarett
Hansen, Birgitte Rønde
author_sort Hovmand, Nichlas
collection PubMed
description BACKGROUND: Necrotizing fasciitis is a deep infection of the fascia and subcutaneous tissue with a high mortality rate. Meningitis is an infection of the membranes surrounding the brain with a likewise high mortality rate. Streptococcus pneumoniae is the most frequent cause of bacterial meningitis and it is an extremely rare cause of necrotizing fasciitis. Different subcapsular serotypes of S. pneumoniae are known to have diverse virulence. The serotype 9 N is associated with a high risk of death. CASE PRESENTATION: We report a case of a previously healthy 68-year-old female who presented at our clinic with complaints of pain in her left calf since having experienced a very painful leg cramp 3 weeks prior. Within a few hours after admission, she developed fever, neck stiffness and an altered mental state. Concurrently, the pain in her leg worsened. Upon further examination it was found that she suffered from both meningitis and necrotizing fasciitis due to S. pneumoniae, serotype 9 N. The patient survived and avoided leg amputation. CONCLUSIONS: The patient suffered from two very lethal infections simultaneously. Both of them were caused by S. pneumoniae. We believe that her favorable outcome was, a result of prompt surgical intervention and appropriate antibiotic treatment. Our case underlines the importance of continuous reevaluation of the symptoms and clinical findings in patients with unclear causes of severe illness, especially if the patient’s condition changes.
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spelling pubmed-64891942019-06-05 Necrotizing fasciitis and meningitis due to Streptococcus pneumoniae serotype 9 N: a case report Hovmand, Nichlas Byberg, Sarah Larsen, Morten Bo Podlekareva, Daria Buck, David Levarett Hansen, Birgitte Rønde BMC Infect Dis Case Report BACKGROUND: Necrotizing fasciitis is a deep infection of the fascia and subcutaneous tissue with a high mortality rate. Meningitis is an infection of the membranes surrounding the brain with a likewise high mortality rate. Streptococcus pneumoniae is the most frequent cause of bacterial meningitis and it is an extremely rare cause of necrotizing fasciitis. Different subcapsular serotypes of S. pneumoniae are known to have diverse virulence. The serotype 9 N is associated with a high risk of death. CASE PRESENTATION: We report a case of a previously healthy 68-year-old female who presented at our clinic with complaints of pain in her left calf since having experienced a very painful leg cramp 3 weeks prior. Within a few hours after admission, she developed fever, neck stiffness and an altered mental state. Concurrently, the pain in her leg worsened. Upon further examination it was found that she suffered from both meningitis and necrotizing fasciitis due to S. pneumoniae, serotype 9 N. The patient survived and avoided leg amputation. CONCLUSIONS: The patient suffered from two very lethal infections simultaneously. Both of them were caused by S. pneumoniae. We believe that her favorable outcome was, a result of prompt surgical intervention and appropriate antibiotic treatment. Our case underlines the importance of continuous reevaluation of the symptoms and clinical findings in patients with unclear causes of severe illness, especially if the patient’s condition changes. BioMed Central 2019-04-29 /pmc/articles/PMC6489194/ /pubmed/31035964 http://dx.doi.org/10.1186/s12879-019-3969-4 Text en © The Author(s). 2019 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Case Report
Hovmand, Nichlas
Byberg, Sarah
Larsen, Morten Bo
Podlekareva, Daria
Buck, David Levarett
Hansen, Birgitte Rønde
Necrotizing fasciitis and meningitis due to Streptococcus pneumoniae serotype 9 N: a case report
title Necrotizing fasciitis and meningitis due to Streptococcus pneumoniae serotype 9 N: a case report
title_full Necrotizing fasciitis and meningitis due to Streptococcus pneumoniae serotype 9 N: a case report
title_fullStr Necrotizing fasciitis and meningitis due to Streptococcus pneumoniae serotype 9 N: a case report
title_full_unstemmed Necrotizing fasciitis and meningitis due to Streptococcus pneumoniae serotype 9 N: a case report
title_short Necrotizing fasciitis and meningitis due to Streptococcus pneumoniae serotype 9 N: a case report
title_sort necrotizing fasciitis and meningitis due to streptococcus pneumoniae serotype 9 n: a case report
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6489194/
https://www.ncbi.nlm.nih.gov/pubmed/31035964
http://dx.doi.org/10.1186/s12879-019-3969-4
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