Group B Streptococcal Necrotizing Fasciitis

—A Case Developed at the Site of Insulin Injection in a Secondary Diabetic Patient—

Abstract

We report a 58-year-old woman with necrotizing fasciitis who developed at the site of subcutaneous insulin injection. Diabetes mellitus due to Cushing syndrome was treated with insulin injection. Skin erythema, induration, warmth, and severe pain were detected on her left upper arm and abdomen, then the patient underwent surgical debridements because necrotizing fasciitis was suspected. Blood culture and cultures of the subcutaneous tissue obtained in the operating room yielded Streptococcus agalactiae. Local inoculation of Group B streptococcus by subcutaneous insulin injection was the likely portal of entry in this patient.