Wound: neutrophils, gram positive cocci in chains (group A Streptococcus) – Shipped August 14, 2017
HISTORY
A simulated arm tissue smear collected from 42 year old female IV drug user with an arm wound and a suspected necrotizing fasciitis diagnosis was sent to category A, B, C, and C1 laboratories.
Participants were instructed to consider the sample as a tissue sample, and were expected to observe and report neutrophils and gram positive cocci in chains.
MAIN EDUCATIONAL POINTS from G172
- Typically, in cases of group A streptococcal necrotizing fasciitis, the Gram stains of aspirated fluids demonstrate gram positive cocci in chains, and few, if any, white blood cells.
- Gram stain results should be reported as soon as they are availa-ble as necrotizing fasciitis is a severe infection; morphological observations, if typical, should be included with the Gram stain report.
