MONOMICROBIAL NECROTIZING FASCIITIS COMPLICATING PREGNANCY AND PUERPERIUM

Background: Necrotizing fasciitis is an uncommon, rapidly progressive, life-threatening infection involving the subcutaneous tissue and fasc ia. Usually, it is a synergistic polymicrobic infection that occurs in patients with coexisting factors predisposing them to bacterial inocu lation and the spread of infection. Cases: We report a monomicrobial v ariant of necrotizing fasciitis affecting three otherwise healthy preg nant or postpartum women. The necrotizing fasciitis involved either th e lower extremity or the abdominal wall. The causative bacteria were S teptococcus pyogenes (two cases) and Staphylococcus aureus (one). All patients presented with an acute fulminant infection, including one wo man who died from overwhelming sepsis. Conclusion: These cases raise a question about the possible role of increased bacterial virulence and the immunologic changes of pregnancy as potential predisposing factor s in the development of necrotizing fasciitis.