SEVERE STREPTOCOCCUS PYOGENES SURGICAL SITE INFECTION AFTER INGUINAL LIPOMA REMOVAL

Abstract

Surgical site infections (SSI) are a common cause of health care-associated infections. They are

localized in the surgical incision site and can lead to deep tissues spreading. Among the wide spectrum

of SSIs , we will consider specifically group A streptococcus cellulitis. This kind of infection can have

a negative evolution and result in necrotizing fasciitis (NF), previously known as streptococcal

gangrene. The term NF indicates a rare necrotizing infection involving any of the soft tissue layers

that still have a high mortality rate from 7% to 76%. An early diagnosis and urgent treatment are key

to ensuring the safety of the patients’ life. A 64-year-old man underwent a complete surgical removal

of an inguinal lipoma. A few hours after the procedure, he developed initial signs of streptococcal

cellulitis. Thanks to an early diagnosis, a multidisciplinary management was established and after 20

days the patient was discharged from our department in good, general clinical conditions. Our

experience has shown how good clinical control and the early evaluation of any clinical warning signs

beginning in the very first few hours after the surgical procedure are important in order to prevent

clinical and local conditions from worsening. Moreover, we underline the great utility of a combined

management led by a multidisciplinary team based on antimicrobial therapy, hyperbaric oxygen

therapy and surgical approach that could be the key to ensure safety of the patients’ life.