Bilateral necrotizing fasciitis of the foot associated with group B streptococcus

Keitaro Fukuda, Misao Ryujin, Reiko Sakio, Satoshi Fukuzumi, Takanori Omae, Kazuhito Hayakawa

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4 Citations (Scopus)


Necrotizing fasciitis (NF) is a severe bacterial infection involving fascia and subcutaneous tissue. It generally affects upper or lower extremities unilaterally, and there are few reports of bilateral-extremity NF. Here, we report a case of a 43-year-old male with type 1 diabetes who had NF on the left foot and subsequently developed NF on the other foot 1 week later. The patient survived with antimicrobial therapy and bilateral below-knee amputation. As group B streptococcus (GBS) was isolated by blood culture and culture of excised tissues of both feet, bilateral GBS NF of the foot was diagnosed. GBS is a rare causative pathogen in NF; however, there have been two case reports of bilateral GBS NF of an extremity in which NF appeared on the opposite extremity 1 week after the primary site infection, as in our case. GBS was isolated from cultures of blood and excised tissues of both extremities in both cases. Together, these observations suggest that GBS has a potential to cause secondary NF at remote sites by hematogenous dissemination with approximately 1 week delay and thereby lead to bilateral NF.

Original languageEnglish
Pages (from-to)243-249
Number of pages7
JournalCase Reports in Dermatology
Issue number3
Publication statusPublished - 2016 Sep 12
Externally publishedYes


  • Diabetes
  • Group B streptococcus
  • Lower extremity
  • Necrotizing fasciitis bilateral

ASJC Scopus subject areas

  • Dermatology


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