Rajack Fareed, Medford Shawn, Ramadan Ali, Naab Tammey
Howard University Hospital, Department of Pathology and Laboratory Medicine, Washington, D.C., United States of America.
Howard University College of Medicine, Washington, D.C., United States of America.
Autops Case Rep. 2024 Jun 21;14:e2024497. doi: 10.4322/acr.2024.497. eCollection 2024.
or Group B (GBS) infections are commonly associated with infections in neonates and pregnant women. However, there has been a rising incidence in nonpregnant adults. The risk of GBS infection in nonpregnant adults is increased for patients of advanced age and those with underlying medical conditions such as diabetes mellitus and cancer. We present a 77-year-old female with type-2 diabetes mellitus, hypertension, and bilateral foot ulcers that presented in probable septic shock with necrotic foot ulcers and necrotizing fasciitis and underwent bilateral lower limb amputations. The patient fulfilled the Streptococcal Toxic Shock Syndrome (STSS) criteria as defined by The Working Group on Severe Streptococcal Infections. These criteria were created for group A Streptococcus (). Our patient fulfilled the Working Group's criteria, except that the blood culture was positive for group B Streptococcus (). Numerous studies demonstrate the importance of early detection and antibiotic treatment for GBS infections in general and early surgical management for necrotizing soft tissue infections (NSTIs) such as necrotizing fasciitis.
B组链球菌（GBS）感染通常与新生儿和孕妇感染有关。然而，非孕成年人中的发病率一直在上升。高龄患者以及患有糖尿病和癌症等基础疾病的非孕成年人发生GBS感染的风险会增加。我们报告一名77岁女性，患有2型糖尿病、高血压和双侧足部溃疡，出现可能的感染性休克，伴有足部溃疡坏死和坏死性筋膜炎，并接受了双侧下肢截肢手术。该患者符合严重链球菌感染工作组定义的链球菌中毒性休克综合征（STSS）标准。这些标准是针对A组链球菌制定的。我们的患者符合工作组的标准，只是血培养结果显示B组链球菌阳性。许多研究表明，总体而言，早期检测和抗生素治疗对GBS感染很重要，对于坏死性软组织感染（NSTIs）如坏死性筋膜炎，早期手术治疗也很重要。
