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BMC Infect Dis. 2019 Apr 29;19(1):358. doi: 10.1186/s12879-019-3969-4.

Necrotizing fasciitis and meningitis due to Streptococcus pneumoniae serotype 9 N: a case report.

Author information

1
Department of Infectious Diseases, Copenhagen University Hospital, Hvidovre, Denmark. nichlashovmand@me.com.
2
Department of Endocrinology, Copenhagen University Hospital, Hvidovre, Denmark.
3
Department of Orthopedics, Copenhagen University Hospital, Hvidovre, Denmark.
4
Department of Infectious Diseases, Copenhagen University Hospital, Rigshospitalet, Denmark.
5
Department of Intensive Care, Copenhagen University Hospital, Rigshospitalet, Denmark.
6
Department of Infectious Diseases, Copenhagen University Hospital, Hvidovre, Denmark.

Abstract

BACKGROUND:

Necrotizing fasciitis is a deep infection of the fascia and subcutaneous tissue with a high mortality rate. Meningitis is an infection of the membranes surrounding the brain with a likewise high mortality rate. Streptococcus pneumoniae is the most frequent cause of bacterial meningitis and it is an extremely rare cause of necrotizing fasciitis. Different subcapsular serotypes of S. pneumoniae are known to have diverse virulence. The serotype 9 N is associated with a high risk of death.

CASE PRESENTATION:

We report a case of a previously healthy 68-year-old female who presented at our clinic with complaints of pain in her left calf since having experienced a very painful leg cramp 3 weeks prior. Within a few hours after admission, she developed fever, neck stiffness and an altered mental state. Concurrently, the pain in her leg worsened. Upon further examination it was found that she suffered from both meningitis and necrotizing fasciitis due to S. pneumoniae, serotype 9 N. The patient survived and avoided leg amputation.

CONCLUSIONS:

The patient suffered from two very lethal infections simultaneously. Both of them were caused by S. pneumoniae. We believe that her favorable outcome was, a result of prompt surgical intervention and appropriate antibiotic treatment. Our case underlines the importance of continuous reevaluation of the symptoms and clinical findings in patients with unclear causes of severe illness, especially if the patient's condition changes.

KEYWORDS:

Infection; Meningitis; Necrotizing fasciitis; Streptococcus pneumoniae

PMID:
31035964
PMCID:
PMC6489194
DOI:
10.1186/s12879-019-3969-4
[Indexed for MEDLINE]
Free PMC Article

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