Volume 11
Number 4
Oct 2007
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Case Reports
RB Mathoera, PC Wever, E van den Aker, CPC de Jager

Transobturator tape placement has been advocated as a fast intervention for stress incontinence that has few complications. Infectious complications have generally been attributed to vaginal erosion, soft tissue infection and abscesses and have mostly remained localized. We describe a patient with necrotizing fasciitis caused by invasive group A Streptococcus following transobturator tape placement. The clinical diagnosis was acute necrotising fasciitis which was treated with polyclonal intravenous immunoglobulins in addition to antibiotics (penicillin and clindamy- cin) and conservative surgical treatment.
The use of polyclonal intravenous immunoglobulins is a novel medical treatment whose beneficial effects have been demonstrated in fulminate invasive group A Streptococcus infections, such as necrotising fasciitis and Streptococcal Toxic Shock Syndrome. Its mechanical actions include neutralization of exotoxins and superantigens, bacterial opsonization and anti-inflammatory effects. Necrotising fasciitis caused by invasive group A Streptococcus can occur as a severe complication of transobturator tape placement.

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