Successful use of intravenous steroids and pentoxifylline in the treatment of bullous hemorrhagic cellulitis

Abstract

Bullous hemorrhagic cellulitis is a severe bacterial infection characterized by the rapid development of hemorrhagic bullae, skin necrosis and possible progression to necrotizing fasciitis. It is caused by a number of organisms including group A beta hemolytic streptococcus, gram negatives and anaerobes. The pathogenesis of group A beta hemolytic streptococcal infection, apart from the inherent strain virulence, is felt to be in part due to tumor necrosis factor (TNF) alpha production by the host. We present a case of bullous hemorrhagic cellulitis due to group A beta hemolytic streptococcus successfully treated with the addition of IV steroids and pentoxifylline to the antibiotic regimen. Both corticosteroids and pentoxifylline inhibit TNF alpha activity and its secretion by macrophages.

Key Words:

• Bullous hemorrhagic cellulitis
• IV steroids
• pentoxifylline
• combination therapy