Retiform purpura as a sign of necrotizing cellulitis in an immunocompetent boy

Nader Aboul-Fettouh, Khang D. Nguyen, Arturo R. Dominguez

Research output: Contribution to journalArticlepeer-review


Severe group A streptococcus (GAS) infections, particularly necrotizing soft tissue infections (NSTIs), have been associated with the development of streptococcal toxic-shock syndrome (STSS), a systemic illness caused by GAS-derived toxins. Traditional physical examination findings in NSTIs include skin necrosis, crepitus, and hemorrhagic bullae. However, these findings are limited in sensitivity and additional clinical markers may aid in making an early diagnosis of NSTI. We present a case of a superficial infection, specifically GAS necrotizing cellulitis, complicated by STSS in a healthy boy with an associated skin finding of retiform purpura that aided in early diagnosis of a NSTI.

Original languageEnglish (US)
Pages (from-to)e646-e648
JournalPediatric emergency care
Issue number11
StatePublished - Nov 1 2020


  • necrotizing soft tissue infection
  • retiform purpura
  • streptococcal toxic shock

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Emergency Medicine


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