Outcomes of invasive Strep A infections of upper limb treated in a regional centre over a period of a one year: case series and literature review

Consequences of Strep A infections can be severe including shock, sepsis, significant tissue destruction, and death. The primary aim of the study was to identify any consistent patterns regarding presentation, patient demographics, and outcomes for patients diagnosed with invasive Strep A infections of the upper limb. A retrospective review of all patients admitted to the plastic surgery department at the Ulster Hospital, Belfast over a 1 year period was conducted. Eighteen patients in total were identified. One third of the patients had documented substance abuse issues. Two thirds of patients needed two or more operative interventions in order to manage their infection. Three patients had digits terminalised (16.6%). Four patients needed tissue coverage following debridement’s, included two skin grafts, one free flap and one pedicled flap. In summation, any individual presenting with a suspected Strep A infection of the upper limb needs urgent review by an appropriate surgical team and vigilant monitoring.