Group A streptococcal necrotizing fasciitis complicating primary varicella: a series of fourteen patients

We retrospectively reviewed the clinical course of group A Streptococcus necrotizing fasciitis complicating primary varicella in children admitted to Children's Hospital and Medical Center, Seattle, WA, during a 18-month period. The potential benefit of various therapeutic interventions was exa...

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Bibliographic Details
Published inThe Pediatric infectious disease journal Vol. 14; no. 7; p. 588
Main Authors Brogan, T V, Nizet, V, Waldhausen, J H, Rubens, C E, Clarke, W R
Format Journal Article
LanguageEnglish
Published United States 01.07.1995
Subjects
Anti-Bacterial Agents
Anti-Inflammatory Agents, Non-Steroidal - therapeutic use
Chickenpox - complications
Child
Child, Preschool
Combined Modality Therapy
Debridement
Drug Therapy, Combination - therapeutic use
Fasciitis, Necrotizing - etiology
Fasciitis, Necrotizing - physiopathology
Fasciitis, Necrotizing - therapy
Female
Humans
Hyperbaric Oxygenation
Infant
Male
Retrospective Studies
Treatment Outcome
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Summary:We retrospectively reviewed the clinical course of group A Streptococcus necrotizing fasciitis complicating primary varicella in children admitted to Children's Hospital and Medical Center, Seattle, WA, during a 18-month period. The potential benefit of various therapeutic interventions was examined. Fourteen children ages 6 months to 10 years were treated for group A Streptococcus necrotizing fasciitis as a complication of primary varicella. Eight patients experienced a delay in initial diagnosis as a result of nonspecific, early clinical findings of necrotizing fasciitis. Each patient underwent surgical exploration with fasciotomies and debridement. Initial antibiotic therapy was broad spectrum and included clindamycin. Hyperbaric oxygen therapy for as many as 6 treatments was used as adjunctively therapy in 12 patients, with subjective benefit in 6 patients. All 14 patients were discharged home with good function and no long term sequelae. This potentially fatal bacterial infection of the deep fascial layers requires early recognition by primary care physicians and an intensive, multidisciplinary therapeutic approach, including thorough surgical debridement and appropriate antibiotic therapy.
ISSN:0891-3668
DOI:10.1097/00006454-199507000-00007