SEVERE STREPTOCOCCUS PYOGENES SURGICAL SITE INFECTION AFTER INGUINAL LIPOMA REMOVAL

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.