Necrotic Bullous Erysipelas

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Abstract
During the last few years streptococcal infections have been reported in connection with various cutaneous manifestations with severe or fatal outcome. A 62-year-old female with chronic interstitial nephritis was admitted with progression of confluent bullous lesions on her right leg. She had contracted a superficial scratch on her right foot 2 days prior to admission. Within 16 hours she deteriorated rapidly with symptoms on sepsis. Blood cultures and cutaneous swabs disclosed growth of beta-haemolytic streptococci group A. In spite of correct penicillin treatment she died 28 hours after admission. Skin biopsies from her right leg showed severe necrosis. This report is a reminder that new, cutaneous manifestations of streptococcal disease are still emerging.