Group B Streptococcal Cellulitis and Necrotizing Fasciitis in Infants: A Systematic Review.

Group B Streptococcal Cellulitis and Necrotizing Fasciitis in Infants: A Systematic Review.

Pediatr Infect Dis J. 2018 Feb 07;:

Authors: Wojtera M, Cheng H, Fiorini K, Coughlin K, Barton M, Strychowsky J

Abstract
BACKGROUND: There is no consensus regarding approaches to infantile group B streptococcal (GBS) head and neck cellulitis and necrotizing fasciitis. We present a case of GBS necrotizing cellulitis and summarizes the literature regarding the presentation and management of infantile head and neck GBS cellulitis and necrotizing fasciitis.
METHODS: The literature was searched using PubMed, Web of Science, EMBASE, and Medline (inception to April 2017) by two independent review authors. Inclusion criteria encompassed case reports or case series of infants less than 12 months of age with GBS cellulitis of the head and neck, or with GBS necrotizing fasciitis without restriction to the head and neck. Data were extracted using tables developed a priori by two independent review authors, and discrepancies were resolved by consensus.
RESULTS: An infant presenting at 33 days of age with GBS facial necrotizing fasciitis was successfully treated conservatively with antibiotics. Our literature search identified 40 infants with GBS head and neck cellulitis. Late-onset (98%), male gender (65%), and prematurity (58%) predominated. Penicillins were the main therapy used (97%). The 12 identified cases of necrotizing fasciitis were associated with polymicrobial etiology (36%) and broad-spectrum antibiotic use. Seventy-five percent required debridement, including four of five (80%) cases involving the head and neck.
CONCLUSIONS: Skin and soft tissue involvement is an uncommon manifestation of late-onset GBS infection which requires antibiotic therapy and possibly surgical debridement cases with necrotizing fasciitis.

PMID: 29424798 [PubMed - as supplied by publisher]

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