1/2. Wound erysipelas following appendectomy caused by group B beta-hemolytic Streptococcus (streptococcus agalactiae).BACKGROUND: Case description of a patient who developed erysipelas of the surgical wound following appendectomy for acute appendicitis, and literature review of invasive group B streptococcal infections. methods: A 65-year-old man with perforated appendicitis underwent urgent appendectomy and drainage. antibiotic prophylaxis with tobramycin (100 mg) and metronidazole (500 mg) was administered. At surgery, a phlegmon was identified with free perforation of the appendix and purulent peritoneal fluid. appendectomy, irrigation with 0.9% NaCl solution, and drainage with a Silastic closed-suction drain was performed. A literature search in all languages was performed using medline, using the search terms surgical site infection, wound infection, group B streptococcus, streptococcus agalactiae, necrotizing fasciitis, and postoperative infection. RESULTS: erysipelas of the surgical wound developed on the fourth postoperative day. Intravenous penicillin and amoxicillin/clavulanic acid were administered empirically. culture of the wound drainage identified streptococcus agalactiae and a few colonies of escherichia coli. The broad-spectrum antibiotic was discontinued, and a 10-day course of penicillin was completed. CONCLUSIONS: erysipelas of the surgical wound is unusual, and infection with group B streptococci is rare compared with infection by group A streptococci. streptococcus agalactiae is recognized to be increasingly virulent, with an increasing predilection for bacteremic infections in healthy hosts. Although streptococcus agalactiae remains highly susceptible to antimicrobial agents effective against gram-positive cocci, the changing epidemiology and potentially invasive nature of these infections should have clinicians alert to the possibility of infection caused by group B streptococci.- - - - - - - - - - ranking = 1keywords = streptococcus (Clic here for more details about this article) |
2/2. Recurrent erysipelas caused by group B streptococcus organisms.Group B beta-hemolytic streptococcus (GBS) has emerged as a major cause of neonatal infections. Serious GBS infections in adults occur most frequently when predisposing illness is present. Recurrent erysipelas caused by GBS is reported in a woman who had chronic lymphedema after a radical hysterectomy and radiation therapy. Type III GBS was identified from cultures of vulvar vesicles, vaginal mucosa, and blood. Prophylactic penicillin v potassium therapy prevented further episodes of erysipelas. Group B beta-hemolytic streptococcus should be considered a possible cause of erysipelas or cellulitis.- - - - - - - - - - ranking = 6keywords = streptococcus (Clic here for more details about this article) |