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An autopsy case of necrotizing fasciitis with rapidly progressive purpura caused by hemolytic streptococcal infection in a patient with rheumatoid arthritis

  • Case Report
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Modern Rheumatology

Abstract

A 77-year-old woman with rheumatoid arthritis was admitted as an emergency because of pain in the right leg with purpura. She was diagnosed with severe cellulitis and sepsis and started on intravenous antibiotics; however, the lesion rapidly extended to the proximal thigh and she died only 38 h after the onset of the first symptom. Autopsy and tissue culture revealed necrotizing fasciitis caused by Streptococcus dysgalactiae subspecies equisimilis. Physicians should consider that necrotizing fasciitis may be present when soft-tissue disorder is suspected in patients receiving corticosteroid therapy, which is associated with tissue fragility and immunosuppression.

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Authors and Affiliations

  1. Department of Rheumatology, Sagamihara National Hospital, National Hospital Organization, 18-1 Sakuradai, Minami-ku, Sagamihara, Kanagawa, 252-0392, Japan

    Kanako Iwata, Yoshiyuki Arinuma, Hisanori Nakayama, Shinichi Nogi, Hidekazu Futami, Hirokazu Takaoka, Atsushi Hashimoto, Kota Shimada & Toshihiro Matsui

  2. Department of Rheumatology, Clinical Research Center for Allergy and Rheumatology, Sagamihara National Hospital, National Hospital Organization, Sagamihara, Kanagawa, 252-0392, Japan

    Akiko Komiya & Shigeto Tohma

  3. Department of Pathology, Sagamihara National Hospital, National Hospital Organization, Sagamihara, Kanagawa, 252-0392, Japan

    Ikuo Saito

Authors
  1. Kanako Iwata
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  2. Yoshiyuki Arinuma
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  3. Hisanori Nakayama
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  4. Shinichi Nogi
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Corresponding author

Correspondence to Yoshiyuki Arinuma.

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Iwata, K., Arinuma, Y., Nakayama, H. et al. An autopsy case of necrotizing fasciitis with rapidly progressive purpura caused by hemolytic streptococcal infection in a patient with rheumatoid arthritis. Mod Rheumatol 21, 669–672 (2011). https://doi.org/10.1007/s10165-011-0454-3

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  • DOI: https://doi.org/10.1007/s10165-011-0454-3

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