Abstract
We report a rare case of necrotizing fasciitis not by group A but by group B Streptococcus. An 80-year-old man who had medicated diabetes with hypoglycemic drugs complained of painful erythema in lower abdomen when he arrived at our emergency room. His body temperature was 38°C and CRP was 65.7mg·dl-1. Subcutaneous gases revealed by computed tomography suggested gas gangrene in the lower abdomen. He immediately underwent extensive debridement of necrotic tissues and put on a ventilator postoperatively in ICU. An open wound was irrigated with acid water everyday and prostaglandin E1 was infused in expectation of improving wound microcirculation. Skin graft surgery on the 12th day successfully covered the wound and the patient was discharged from ICU on the 14th day. Group B Streptococcus was detected in culture of necrotic tissue. Necrotizing fasciitis caused by group B Streptococcus is as catastrophic as that of group A Streptococcus. Early and extensive debridement, wound irrigation, and administration of appropriate antibiotics and prostaglandin E1 resulted in good recovery.
