VA Puget Sound Health Care System, Seattle, WA.
MultiCare Auburn Medical Center, Auburn, WA.
Wounds. 2023 Feb;35(2):E74-E77. doi: 10.25270/wnds/22044.
Streptococcus constellatus is commensal flora of the oropharyngeal, gastrointestinal, and genitourinary tracts with a proclivity for abscess formation. Bacteremia due to S constellatus is rare; however, rising incidences have been reported, particularly in patients with diabetes. Prompt surgical debridement and antibiotic therapy with a cephalosporin are the mainstays of treatment.
The case presented here involves a patient with poorly controlled diabetes who had necrotizing soft tissue infection secondary to S constellatus. The infection originated from bilateral diabetic foot ulcerations that led to bacteremia and sepsis.
Immediate source control with wide and aggressive surgical debridement, initial empiric broad-spectrum antibiotic therapy followed by tailored treatment based on deep operative cultures, and staged closure led to effective limb-salvage and life-sparing intervention for this patient.
星座链球菌是口腔、胃肠道和泌尿生殖道的共生菌群，易形成脓肿。由 S 星座链球菌引起的菌血症较为罕见；然而，据报道发病率正在上升，尤其是在糖尿病患者中。及时的手术清创和头孢菌素类抗生素治疗是主要的治疗方法。
本病例涉及一位血糖控制不佳的糖尿病患者，他患有由 S 星座链球菌引起的坏死性软组织感染。感染源于双侧糖尿病足溃疡，导致菌血症和败血症。
通过广泛而积极的手术清创、初始经验性广谱抗生素治疗，然后根据深部手术培养结果进行针对性治疗，以及分期闭合，为该患者进行了有效的保肢和挽救生命的干预。
