Monomicrobial necrotizing fasciitis complicating pregnancy and puerperium
McHenry, C.R.; Azar, T.; Ramahi, A.J.; Collins, P.L.
Obstetrics and Gynecology 87(5 Pt 2): 823-826
1996
ISSN/ISBN: 0029-7844 PMID: 8677102 Document Number: 462750
Background: Necrotizing fasciitis is an uncommon, rapidly progressive, life-threatening infection involving the subcutaneous tissue and fascia. Usually, it is a synergistic polymicrobic infection that occurs in patients with coexisting factors predisposing them to bacterial inoculation land the spread of infection. Cases: We report a monomicrobial variant of necrotizing fasciitis affecting three otherwise healthy pregnant or post- partum women. The necrotizing fasciitis involved either the lower extremity or the abdominal wall. The causative bacteria were Streptococcus pyogenes (two cases) and Staphylococcus aureus (one). All patients presented with an acute fulminant infection, including one woman who died from overwhelming sepsis. Conclusion: These cases raise a question about the possible role of increased bacterial virulence and the immunologic changes of pregnancy as potential predisposing factors in the development of necrotizing fasciitis.