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- Title
Paniculite por Streptococcus pyogenes.
- Authors
Fidalgo Martins, Inês; Milheiro Silva, Tiago; João Brito, Maria
- Abstract
Panniculitis refers to disorders with the inflammation of the subcutaneous tissue. Infectious panniculitis is rare in childhood and an unusual presentation of Group A b-haemolytic streptococcus (GABHS) infection. A 13-month-old, previously healthy girl, presented with a three-day fever (> 39°C) and erythematous, non pruriginous rash on her thorax, abdomen, back, and left armpit, which progressed to palpable, non-painful, subcutaneous, nodules with an erythematopurpuric halo. Physical examination revealed an irritable infant, with tachycardia. Laboratory testing showed anaemia, leukocytosis with neutrophilia, and CRP 171 mg/L. Soft tissue ultrasound was compatible with panniculitis with no abscessed areas. Streptococcus pyogenes was isolated from a blood culture. Penicillin and clindamycin were started, with sustained apyrexia starting from the fourth day of treatment. The lesions progressively regressed. Due to the refusal of right plantar support, an MRI was performed revealing the osteomyelitis of the right astragalus. She maintained antibiotic treatment with amoxicillin after discharge for 4 weeks, with the complete resolution of the complaints. Conclusion: Infectious panniculitis is a rare condition in childhood especially without immunodeficiency. GABHS may be the cause of infectious panniculitis, but is not a frequent agent, making this specific case particularly interesting.
- Subjects
STREPTOCOCCUS pyogenes; ADIPOSE tissue diseases; CLINDAMYCIN; ASTRAGALUS (Plants); TACHYCARDIA; AMOXICILLIN; AXILLA; FEVER
- Publication
RPDI - Revista Portuguesa de Doenças Infecciosas, 2022, Vol 17, Issue 1-3, p25
- ISSN
0870-1571
- Publication type
Article