Necrotizing Fasciitis Due to Group A Streptococcus after an Accidental Needle-Stick Injury

Abstract

To the Editor: While inserting a central venous catheter into a patient newly admitted to our hospital with sepsis of unknown cause, a healthy, 27-year-old resident was scratched on the dorsal aspect of her left fifth metacarpal–phalangeal joint by the needle used to insert the catheter. Within 14 hours, she noticed erythema, induration, and pain in her left hand. Shortly thereafter she had chills and fever (temperature, 38.4°C [101.1°F]), and nafcillin therapy was begun. Penicillin G and clindamycin were added when it became known that the patient the resident had treated died 12 hours after admission from group A streptococcus . . .