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.
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