• Br J Anaesth · Mar 2004

    Case Reports

    Fatal streptococcal necrotizing fasciitis as a complication of axillary brachial plexus block.

    • S Nseir, P Pronnier, S Soubrier, T Onimus, F Saulnier, D Mathieu, and A Durocher.
    • Service de Réanimation Médicale, Hôpital Calmette, CHRU, boulevard du Pr Leclercq, F-59037 Lille cedex, France. s-nseir@chru-lille.fr
    • Br J Anaesth. 2004 Mar 1;92(3):427-9.

    AbstractA 74-yr-old diabetic woman developed necrotizing fasciitis of the right upper limb after axillary brachial plexus block for carpal tunnel decompression. Clinical signs included oedema, diffuse swelling and bullae; rapidly followed by toxic shock syndrome and multiorgan failure. The patient died 48 h after hospital admission, despite broad-spectrum antibiotics, surgical treatment and supportive measures for the management of shock and multiorgan failure. Cultures yielded group A Streptococcus. Delay in antibiotic and surgical treatment probably affected the outcome. Early diagnosis and treatment are essential to improve the outcome of streptococcal necrotizing fasciitis.

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