Necrotizing fasciitis and toxic shock-like syndrome caused by group B streptococcus

A recent increase in reports of necrotizing fasciitis resulting from group B streptococcus has alerted physicians to a possible concomitant increase o f toxic shock-like syndrome. We report the second case of group B streptoco ccus causing necrotizing fasciitis and toxic shock-like syndrome. A black w oman, aged 52 years, with newly diagnosed diabetes mellitus had necrotizing fasciitis type II of the left groin. Hypotension, elevated bilirubin and l iver enzymes, and adult respiratory distress syndrome rapidly developed, Be cause group B streptococcus was isolated from a normally sterile site, the patient's condition met the criteria for toxic shock-like syndrome. Extensi ve surgical debridement, hyperbaric oxygen therapy and intravenous antibiot ic therapy (including clindamycin) were required for complete recovery. The antitoxin effects of hyperbaric oxygen therapy and clindamycin should be f urther investigated for the treatment of such patients.