Cellulitis and bacteraemia caused by Streptococcus dysgalactiae post radical vulvectomy and bilateral inguinal lymph node dissection for FIGO IB squamous cell carcinoma of the vulva, a case report

BACKGROUND: Streptococcus dysgalactiae, also known as Group C/G Streptococci, causes infection to humans and animals. Infectious syndromes range from mild pharyngitis and cellulitis, to bacteraemia and life-threatening sepsis. This report uniquely presents a case of Streptococcus dysgalactiae subspecies dysgalactiae causing fulminant sepsis post-radical vulvectomy. CASE: Four months post modified radical vulvectomy with bilateral lymph node dissection, a 78-year-old woman presented with pyrexia and associated intercrural, upper thigh and suprapubic erythema. Aside from being a smoker, there was no documented history of immunosuppression. Blood cultures yielded growth of S. dysgalactiae, and she improved with intravenous antibiotics, fluid resusitation and electrolyte replacement. CONCLUSION: Streptococcus dysgalactiae is an important pathogen associated with bacteraemia, cellulitis, meningitis and pneumonia. Prompt and appropriate antibiotic therapy in addition to further investigations with potential surgical intervention are essential.