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Necrotizing Fasciitis of the Scalp in a Newborn

From the ¹Department of Perinatal-Neonatal Medicine, University of Toronto/Hospital for Sick Children, Toronto, Ontario, Canada.

BACKGROUND: Fetal scalp electrode monitoring is usually without complications, but on rare occasions it can serve as a portal of entry for organisms colonizing the maternal genital tract.

CASE: We present a case of neonatal necrotizing fasciitis of the scalp that was associated with intrapartum fetal scalp electrode monitoring. Skin cultures grew Group A Streptococcus M11 T nontypeable serotype, an unusual cause of neonatal necrotizing fasciitis. The neonate’s mother had a concurrent perineal infection and the same Group A streptococcal serotype was cultured from maternal blood and vaginal swabs.

CONCLUSION: This case highlights the emergence of life-threatening Group A Streptococcus causing invasive disease in both infants and mothers and the need for careful monitoring of neonates who have had intrapartum electrode monitoring.