Strep infection from a small wound on the leg

Mr. Hien, 36 years old, suffered a minor injury to his right foot, then the redness and swelling spread. Tests confirmed Streptococcus pyogenes infection.

Mr. Hien injured his foot while traveling by sea, suspected to be caused by an underwater creature. About 12 hours later, the damaged area began to swell and hurt, he had a fever and was very tired.

Dr. Nguyen Hoang Anh Duy, Department of General Internal Medicine, Tam Anh General Hospital, Ho Chi Minh City, said the inside of his right big toe had two small wounds, each about 2 mm, oozing cloudy fluid. The right foot was swollen, hot, red and painful, the wound quickly spread from the toes up to near the right knee. The patient has a fever of 38.7 degrees Celsius and chills, feeling tired and without energy.

Ultrasound results showed edema and soft tissue fluid collection in the foot area. Tests showed signs of infection, while the inflammation continued to spread. The patient was treated at the Intensive Care – Poison Control Department (ICU). In the first days, he continuously had high fever, redness and swelling from the feet to the lower legs, spreading to the thighs and groin area. CRP index – a sign that reflects the level of inflammation in the body, increased above 400 mg/L, 80 times higher than normal.

The medical team used a variety of broad-spectrum antibiotics and took blood and fluid samples from the wound to find the cause. The pus culture results later determined that the causative agent was Streptococcus pyogenes.

According to Dr. Duy, Streptococcus pyogenes is a bacteria that often exists on the skin or in the living environment, and can cause dermatitis, soft tissue inflammation and many other types of infections. When bacteria enter through a scratch or small injury on the skin, they can spread quickly into the tissues under the skin, causing red, hot, painful swelling. In some cases, bacteria also secrete toxins that stimulate the body’s strong inflammatory response, leading to high fever, widespread infection and the risk of sepsis if not treated promptly.

Dr. Duy explained that this result shows that the infection is not characteristic of a specific type of bacteria from marine animals. It is likely that the bacteria penetrated through the damaged skin, then caused soft tissue inflammation and a systemic infection reaction.

During the treatment process, Mr. Hien was discovered to have type 2 diabetes. According to Dr. Duy, patients are more susceptible to infection because prolonged high blood sugar reduces immunity and damages small blood vessels, causing poor blood and oxygen to reach tissues and slow wound healing. “Even small skin damage can become a “gateway” for bacteria to enter, causing serious infection,” said Dr. Duy.

After three days of intensive treatment, the patient had no fever, pain and swelling gradually decreased, the damaged area narrowed and no longer oozed pus. Two weeks later, the patient appeared.

Doctors recommend that people with skin wounds due to contact with foreign organisms or during work and daily activities need close monitoring. If the wound is red and swollen, has increased pain, is oozing fluid or has a fever, the patient needs to go to a medical facility for early examination. People with diabetes and chronic diseases should have regular health checks and comply with treatment to control underlying diseases, reduce the risk of infection and promote wound healing.