[Skip to Content]
Sign In
Individual Sign In
Create an Account
Institutional Sign In
OpenAthens Shibboleth
[Skip to Content Landing]
Article
May 1982

The Changing Pattern of Hemolytic Streptococcal Gangrene

Author Affiliations

From the Department of Surgery, Loma Linda (Calif) University School of Medicine.

Arch Surg. 1982;117(5):561-567. doi:10.1001/archsurg.1982.01380290029006
Abstract

• We reviewed nine cases in which either limb-threatening or life-threatening complications developed due to streptococcal infection. Our findings indicate important changes in the pattern of this fulminating illness since its original description in 1924. A higher mortality reflects increased longevity with a greater frequency of impaired host resistance and degenerative diseases involving vital organs. Initial symptoms and signs often mimic acute thrombophlebitis, acute arthritis, deep soft-tissue trauma, or acute vascular occlusion. The emergence of multiple organ failure and serious coagulation disorders are a challenge to current therapy. A diagnostic algorithm was developed to aid in the early diagnosis and management of this life-threatening infection.

(Arch Surg 1982;117:561-567)

References
1.
Meleney FL:  Hemolytic streptococcus gangrene . Arch Surg 1924;9:317-364.Article
2.
Mubarak SJ, Hargens AR, Owen CA, et al:  The wick catheter technique for measurement of intramuscular pressure: A new research and clinical tool . J Bone Joint Sury Am 1976;58:1016-1020.
3.
Hargens AR, Akeson WH, Mubarak SJ, et al:  Fluid balance within the canine anterolateral compartment and its relationship to compartment syndromes . J Bone Joint Sury Am 1978;60:499-505.
4.
Davis DB, Dulbecco R, Eisen HN, et al:  Streptococci , in Davis BD, Dulbecco R, Eisen HN, et al (eds): Microbiology . New York, Hoeber Publishing, 1969, pp 701-725.
5.
Kavaler L:  Streptococcal disease , in Breese BB, Dillon HC, Kaplan MH, et al (eds): Streptococcal Disease . Kalamazoo, Mich, Maher-Wade Inc, 1974, p 8.
6.
Jones J:  Investigations upon the nature, causes and treatment of hospital gangrene as it prevailed in the Confederate armies 1861-1865 , in Hamilton FH (ed): United States Sanitary Commission . Memoirs: Surgical II. New York, Riverside Press, 1871, pp 146-170.
7.
Meleney FL:  Bacterial synergism in disease processes with a confirmation of the synergistic bacterial etiology of a certain type of progressive gangrene of the abdominal wall . Ann Surg 1931;94:961-981.Article
8.
Meleney FL:  A differential diagnosis between certain types of infectious gangrene of the skin . Surg Gynecol Obstet 1933;56:847-867.
9.
Meleney FL:  Hemolytic streptococcus gangrene: Importance of early diagnosis and early operation . JAMA 1929;92:2009-2012.Article
10.
Meleney FL:  Haemolytic streptococcus gangrene following the administration of scarlet fever antitoxin . Ann Surg 1930;92:287-289.
11.
Dellinger EP:  Severe necrotizing soft-tissue infections: Multiple disease entities requiring a common approach . JAMA 1981;246:1717-1721.Article
12.
Maclennan JD:  The histotoxic clostridial infections of man . Bacteriol Rev 1962;26:177-274.
13.
Weinstein L, Barza MA:  Gas gangrene . N Engl J Med 1973;289:1129-1131.Article
14.
Altemeier WA, Culbertson WR:  Acute non-clostridial crepitant cellulitis . Surg Gynecol Obstet 1948;87:206-212.
15.
Stone HH, Martin JD:  Synergistic necrotizing cellulitis . Ann Surg 1972;175:702-711.Article
16.
Wilson B:  Necrotizing fasciitis . Am Surg 1952;18:416-431.
17.
Rea WJ, Wyrick WJ Jr:  Necrotizing fasciitis . Ann Surg 1970;172:957-964.Article
18.
Rudolph R, Soloway M, DePalma RG, et al:  Fournier's syndrome: Synergistic gangrene of the scrotum . Am J Surg 1975;129:591-596.Article
19.
Matsen FA:  Compartmental syndrome . Clin Orthop 1975;113:8-14.Article
20.
Mubarak S, Owen CA:  Compartmental syndrome and its relation to the crush syndrome: A spectrum of disease . Clin Orthop 1975;113:81-89.Article
21.
Nossel HL:  Disorders of blood coagulation factors , in Isselbacher KJ, Adams RD, Braunwald W, et al (eds): Harrison's Principles of Internal Medicine , ed 9. New York, McGraw-Hill Book Co, 1980, pp 1560-1568.
22.
Coleman RW, Robboy SJ, Minna JD:  Disseminated intravascular coagulation (DIC): An approach . Am J Med 1972;52:679-689.Article
23.
Yoshikawa T, Tanaka KR, Guze LB:  Infection and disseminated intravascular coagulation . Medicine 1971;50:237-258.Article
×