A case of C3 glomerulopathy with nephritis-associated plasmin receptor positivity without a history of streptococcal infection

Objective: We describe the sudden onset of obsessive—compulsive symptoms fol lowing a peritoneal infection with α-haemolytic streptococci. Clinical picture: A 35–year-old woman with no past history or family history of obsessions or compulsions developed these symptoms 2 weeks after a peritoneal infection. Treatment: The patient received 80 mg fluoxetine daily. Outcome: She responded to treatment with a progressive reduction in symptoms. Conclusions: It is suggested that these obsessions and compulsions may be related to an autoimmune response to the streptococcal infection.

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Neutropenia and T-Wave Inversion as Toxin-Mediated Complications of a Streptococcal Infection

The Journal of Critical Care Medicine ◽

10.1515/jccm-2017-0030 ◽

2017 ◽

Vol 3 (4) ◽

pp. 166-171 ◽

Cited By ~ 1

Author(s):

Cristina Popescu ◽

Anca Leuştean ◽

Alina Elena Orfanu ◽

Codruţa Georgiana Carp ◽

Victoria Aramă

Keyword(s):

Streptococcal Infection ◽

Penicillin G ◽

Severe Neutropenia ◽

Case Presentation ◽

Wave Inversion ◽

History Of ◽

Ecg Abnormalities ◽

Allergic Disorders ◽

Streptococcal Tonsillitis ◽

T Waves

Abstract Introduction: Streptococcal infection can be responsible for multiple complications, such as toxic, septic or allergic disorders. Toxin-mediated complications (TMC) can appear during the acute phase of disease and can involve any organ, causing carditis, arthritis, nephritis, hepatitis etc. Case presentation: The case of a young woman without a history of recurrent streptococcal tonsillitis, admitted to “Matei Balş” National Institute for Infectious Diseases, Bucharest, Romania, presenting with fever, sore throat and exudative tonsillitis, is detailed. The initial test for Streptococcus pyogenes was negative. The patient had leukopenia with severe neutropenia, high values of inflammatory biomarkers and electrocardiographic (ECG) changes with inverted T waves in leads V1-4 and flattened T waves in V5-6. There were no other cardiac signs or symptoms. The patient received cefuroxime for two days. On admission, the patient was prescribed Penicillin G and dexamethasone which resulted in a rapid recovery. The leucocytes count returned to normal as did the ECG abnormalities. At the time of discharge, the antistreptolysin O titre was high. Conclusions: The case highlights the toxin-mediated complications (TMC) of streptococcal infection which occur from the outset of the disease.

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Invasive Group B Streptococcal Infection with Toxic Shock-Like Syndrome in a Postsplenectomy Patient

Case Reports in Infectious Diseases ◽

10.1155/2020/4048610 ◽

2020 ◽

Vol 2020 ◽

pp. 1-3

Author(s):

Pradeep Kumar Mada ◽

Gabriel Castano ◽

Andrew Stevenson Joel Chandranesan

Keyword(s):

Diabetes Mellitus ◽

Streptococcal Infection ◽

Toxic Shock ◽

Invasive Group ◽

Streptococcal Disease ◽

Control And Prevention ◽

History Of ◽

Group B Streptococcal Disease ◽

Group B ◽

Underlying Risk

The incidence of invasive group B streptococcal disease (GBS) in nonpregnant population is increasing. As per the Centers for Disease Control and Prevention (CDC), there are 10 cases in every 100,000 nonpregnant adults each year, and 1 in 20 nonpregnant adults with serious GBS infections die. GBS infection is almost always associated with underlying risk factors such as diabetes mellitus or malignancy. We present a 47-year-old female with a remote history of splenectomy presented with toxic shock-like syndrome secondary to invasive GBS infection.

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MO136RELATIONSHIP BETWEEN UPCR AND EGFR IN C3 GLOMERULOPATHY

Nephrology Dialysis Transplantation ◽

10.1093/ndt/gfab092.0014 ◽

2021 ◽

Vol 36 (Supplement_1) ◽

Author(s):

Carla Nester ◽

Patrick Breheny ◽

Monica Hall ◽

Alan Charney ◽

Martin Lefkowitz ◽

...

Keyword(s):

Natural History ◽

Small Sample Size ◽

Continuous Variable ◽

Small Sample ◽

C3 Glomerulopathy ◽

University Of Iowa ◽

History Of ◽

Stage Renal Disease ◽

End Stage ◽

The Relationship

Abstract Background and Aims Considerable knowledge gaps exist in our understanding of the natural history of C3 glomerulopathy (C3G). Disease rarity, multiple nomenclature changes, and the inclusion of dissimilar cases in historical cohorts have precluded retrospective studies to define the natural course of C3G and identify risks for progression to kidney failure (end stage renal disease/ESRD). In the present analysis, we focus on C3G patients with native kidneys and examine the relationship between reductions in UPCR and disease progression as indicated by changes in eGFR. Method Patients included in this study were consented and enrolled in the University of Iowa C3G ReCom Registry, which was created in 2013. Beginning in 2017, complement activity and renal function data were collected prospectively at approximately 6-month intervals to define the natural history of C3G. Analyses were performed across 1-year periods of time (“spans”). To be included in a span, a patient had to meet the following criteria at the start of the 1-year period: native C3G, eGFR ≥30 mL/min/1.73 m2, UPCR ≥1 g/g and ≥12 years of age. An individual patient could be included in more than one span. Results Analyses were performed using 34 one-year spans for 24 patients who met inclusion criteria at the beginning of the 1-year span. Baseline characteristics for the 34 spans were: male, 59%; mean age, 22.7 years; mean eGFR, 83.1 ml/min/1.73m2; mean UPCR, 2.86 g/g; mean plasma C3, 75.1 mg/dL. Similar analyses using only the first 1-year span for each of the 24 patients produced results that were consistent with those generated using all 1-year spans. Limitations of this study include its small sample size and data variability due to its observational nature. Conclusion The findings of this observational study support the premise that reductions in proteinuria are associated with a more stable eGFR in native kidney C3G. Regression analyses using UPCR as a continuous variable demonstrate the relationship between reduction in UPCR and preservation of eGFR. This association was also observed using both change in eGFR by UPCR reduction subgroup and UPCR-eGFR categorical analyses.

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Nationwide study of mortality and survival in pregnancy-related streptococcal toxic shock syndrome

10.21203/rs.3.rs-39096/v1 ◽

2020 ◽

Author(s):

Eijiro Hayata ◽

Masahiko Nakata ◽

Junichi Hasegawa ◽

Hiroaki Tanaka ◽

Takeshi Murakoshi ◽

...

Keyword(s):

Early Intervention ◽

Family History ◽

Clinical Data ◽

Toxic Shock Syndrome ◽

Streptococcal Infection ◽

Streptococcal Toxic Shock Syndrome ◽

Antigen Test ◽

Toxic Shock ◽

Initial Symptoms ◽

History Of

Abstract Background Streptococcal toxic shock syndrome is associated with the highest rates of infection-related maternal mortality. We conducted a comparative analysis of background factors and treatment course between patients who survived and those who did not to improve our understanding of the optimal initial treatment approach for this fulminant disease. Methods: A retrospective observational study was conducted based on clinical data collected from two national organizations. Clinical data of patients who died and of those who survived, including background information, clinical course, and treatment administered, were collated. Results: No statistical differences were found between groups for age, parity, season, gestational age, or the patient’s location at the onset of symptoms. After the onset of initial symptoms, survivors were administered antibiotics systematically during their first visit to a clinic (p = 0.006). More survivors had received treatment within 1 hour of onset of fulminant disease (p = 0.069). The number of fetal deaths was significantly higher in the mortality group (p = 0.003), while that of fetal survival was higher in the group of maternal survivors (p = 0.055). Maternal survivors with non-specific initial symptoms received early intervention if there was a family history of group A streptococcal infection or a positive rapid antigen test result. Conclusions Intensive care, including systemic administration of antibiotics, may contribute to maternal survival when administered immediately (within 1 hour) after the onset of fulminant streptococcal toxic shock syndrome. Eliciting a family history of streptococcal infection and conducting a rapid antigen test can identify patients needing early intervention.

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Acute poststreptococcal glomerulo-nephritis in general practice: the contribution of infection to its onset and course

Epidemiology and Infection ◽

10.1017/s0950268800052432 ◽

1996 ◽

Vol 116 (2) ◽

pp. 193-201 ◽

Cited By ~ 4

Author(s):

P. M. Higgins

Keyword(s):

General Practice ◽

Urinary Tract ◽

Urinary Tract Infections ◽

Streptococcal Infection ◽

Secondary Infection ◽

Good Evidence ◽

Active Infection ◽

Acute Infections ◽

History Of ◽

Tract Infections

SUMMARYTwenty-one patients considered to have acute poststreptococcal glomerulo-nephritis were encountered during 35 years of general practice. In ten of them good evidence of active streptococcal infection at the time of discovery of nephritis was recorded. The more complete the data the more convincing was the evidence of active infection.In over half of those whose urines were routinely cultured pathogens were isolated and over a third were treated for infection of the urinary tract. Such infections were associated with adverse effects and prolonged illness.As compared with children, adults in general had a longer history of ill-health, were less likely to present with acute infections and more likely to have urinary tract infections and prolonged illness.Vigorous antistreptococcal treatment was followed by rapid recovery in those patients so treated whose illnesses were not complicated by urinary tract infections.Concurrent streptococcal infection and secondary infection of the urinary tract may contribute more to the onset of acute poststreptococcal glomerulo-nephritis and to its course than is currently believed.

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Obsessive compulsive disorder in adults with rheumatic heart disease

Acta Neuropsychiatrica ◽

10.1111/j.1601-5215.2006.00169.x ◽

2007 ◽

Vol 19 (2) ◽

pp. 118-121 ◽

Cited By ~ 6

Author(s):

Ashfaq-U-Rahaman ◽

Y. C Janardhan Reddy ◽

Prabhavathi ◽

Pramod Kumar Pal

Keyword(s):

Heart Disease ◽

General Population ◽

Rheumatic Heart Disease ◽

Obsessive Compulsive Disorder ◽

Streptococcal Infection ◽

Assessment Tools ◽

Obsessive Compulsive ◽

Compulsive Disorder ◽

History Of ◽

Rheumatic Heart

Objective:There are considerable data on the possible association between streptococcal infection and obsessive compulsive disorder (OCD), particularly the relation between Sydenham’s chorea (SC) and OCD. However, neuropsychiatric sequelae related to streptococcal infection are mainly reported in children. In this preliminary study, we examined prevalence of OCD in a group of adult subjects with established rheumatic heart disease (RHD). We hypothesized that the rate of OCD would be higher than the known general population rates.Method:One hundred adult subjects with RHD were evaluated for OCD and other comorbid psychiatric disorders using well-known psychiatric assessment tools. A qualified psychiatrist conducted the assessments. The diagnoses were made according to DSM-IV criteria.Results:The rate of clinical OCD and subclinical OCD was 10% and 3%, respectively (n = 13), a rate much higher than the 1–3% rate reported in general population. Of the 13 subjects, only three had a history of SC (23%).Conclusions:OCD could be a long-term sequel in adults with a history of rheumatic fever in childhood, even in the absence of frank chorea. The findings call for systematic research in this little explored area.

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Psoriasis Gutata - Laporan Kasus

JURNAL BIOMEDIK (JBM) ◽

10.35790/jbm.10.2.2018.20093 ◽

2018 ◽

Vol 10 (2) ◽

Author(s):

Julieta D. P. Dotulong ◽

Charly M. M. Korompis ◽

Herry E. J. Pandaleke

Keyword(s):

Streptococcal Infection ◽

Topical Steroid ◽

The Body ◽

Trigger Factor ◽

First Line ◽

First Line Therapy ◽

History Of ◽

Erythematous Plaques ◽

Guttate Psoriasis ◽

Case Diagnosis

Abstract: Guttate psoriasis (GP) is a variant of psoriasis with typical drop-shaped lesions sized 0.5-1 cm in diameter, localized especially in the upper part of the body and proximal extremities. It usually occurs in young adult. We reported a female,11 years old, with red, itchy, and scaly patches distributed nearly all over the body. There was a history of sore throat. Dermatologic status showed multiple erythematous plaques which were miliar to numular, discrete, and were covered with layered silvery white scales. The Auspitz sign, wax spot phenomenon, and ASTO were positive. The histopathologic examination showed para-keratosis and Munro microabcesses. The patient treated with topical steroid for 4 weeks made improvement. Conclusion: In this case, diagnosis of guttate psoriasis was based on anamnesis, examination, and supporting examinations. Streptococcal infection was suspected as the trigger factor due to the positive ASTO examination. Topical steroid as the first line therapy for mild to moderate psoriasis made great improvement.Keywords: guttate psoriasis, streptococcal infectionAbstrak: Psoriasis gutata (PG) merupakan varian dari psoriasis. Gambaran khasnya seperti tetesan air dengan diameter 0,5-1 cm, di badan bagian atas dan ekstremitas proksimal. Sering terjadi pada dewasa muda. Kami melaporkan kasus seorang perempuan berusia 11 tahun dengan bercak merah meninggi, bersisik, disertai gatal pada hampir seluruh tubuh. Riwayat nyeri menelan positif. Riwayat pengobatan sebelumnya disangkal. Status dermatologis ditemukan plak eritem, multipel, miliar-numular, diskret, ditutupi skuama berlapis warna putih keperakan. Pemeriksaan tanda Auspitz, fenomena bercak lilin, dan ASTO positif. Pada pemeriksaan histopatologik didapatkan adanya parakeratosis dan mikroabses Munro. Terapi steroid topikal potensi tinggi selama 4 minggu menunjukkan perbaikan. Simpulan: Pada kasus ini diagnosis psoriasis gutata ditegakkan berdasarkan anamnesis, pemeriksaan fisik, dan pemeriksaan penunjang yang khas. Infeksi streptokokus diduga sebagai faktor pencetus berdasarkan hasil pemeriksaan ASTO. Terapi steroid topikal merupakan lini pertama untuk psoriasis ringan sampai sedang memperlihatkan perbaikan yang nyata.Kata kunci: psoriasis gutata, infeksi streptokokus

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