Fulminant group A streptococcal necrotizing fasciitis of the head and neck region

A resurgence of severe group A streptococcal soft tissue infections has been observed in Europe and the United States during the last decade. These infections are characterized by extensive local destruction and systemic toxicity. In this particular entity, necrotizing fasciitis is the most common clinical presentation, usually localized in the lower abdomen or in the limbs. As streptococcal necrotizing fasciitis is associated with a high mortality rate, early diagnosis and aggressive surgical treatment are crucial in the management of these affections. We report a case of group A streptococcal necrotizing fasciitis of the face which is a rare localization. There was no history of trauma or infection in the head and neck region. The condition had a fulminant progression leading to toxic shock syndrome with a fatal outcome.