Two cases of necrotizing fasciitis due to Streptococcus pyogenes in a family with different outcomes

Abstract

This case report describes two cases of necrotizing fasciitis due to Streptococcus pyogenes with different outcomes in a couple. Only the wife developed a fulminant course and died. The pathology of the wife’s lesion site showed weak neutrophilic infiltration. Additionally, the blood culture of the wife revealed a strain with a mutation in the virulence regulator CsrS. In contrast, pathological examination of the husband showed infiltration of numerous neutrophils and no mutation in the virulence regulator of the strain. The findings suggest that mutations in the virulence regulators of the strain might be related to fulminant course and histopathologic findings.