Neonatal Faciocervical Group BStreptococcalNecrotising Fasciitis: a Multidisciplinary Approach to Management

Author:

Pezas Theodore PaulORCID,Fernando JoepORCID,Timoney Norma,Syed Mobinulla,Filson Simon

Abstract

Neonatal necrotising fasciitis secondary toStreptococcus agalactiae, also known as Group BStreptococcus(GBS), is a rare, life-threatening entity with approximately 40 cases reported in the literature. GBS soft tissue infection in infancy most commonly affects the face, likely originating from the colonised oral cavity. In cases unresponsive to medical management alone, early surgical debridement can be life-saving. We present a case of faciocervical GBS necrotising fasciitis in a male neonate requiring multiple surgical debridements. The resultant soft tissue defect healed with topical negative pressure therapy and eventual placement of a double-layer dermal substitute. Due to his prematurity, the patient was not skin grafted to limit donor site morbidity. After recovering from his life-threatening infection, the patient had intensive scar therapy leading to a favourable cosmetic result with no evidence of function-limiting contracture. Our report draws focus to the need for a multidisciplinary approach incorporating therapy-led scar management early in the postsurgical recovery plan.

Publisher

BMJ

Subject

General Medicine

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