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November 1987

Necrotizing Fasciitis Associated With Haemophilus influenzae Type b

Am J Dis Child. 1987;141(11):1146-1148. doi:10.1001/archpedi.1987.04460110016002

Sir.—Necrotizing fasciitis is characterized by wide-spread necrosis of subcutaneous tissue and fascia, without muscle involvement. Numerous aerobic and anaerobic bacteria have been implicated, but in most cases, the primary causative agent is Streptococcus pyogenes. Although uncommon in pediatric practice, this clinical entity has been reported increasingly in children and is associated with substantial morbidity and mortality without aggressive surgical and medical management.1 This case represents the first time Haemophilus influenzae type b (Hib), a common childhood pathogen, has been implicated in this disease. This organism can now be added to the list of bacteria capable of producing this life-threatening disease.

Patient Report.—The patient, a 13-month-old Laotian female infant, presented with a three-day history of fever (temperature unknown), erythema, and swelling of the right foot, without a history of antecedent trauma. She was treated by a community herbal practitioner with various poultices (without cupping) prior to hospitalization and

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