Neonatal Toxic Shock Syndrome–Like Exanthematous Disease in North America

2019 ◽  
Author(s):  
Megan Culler Freeman ◽  
Stephanie Mitchell ◽  
John Ibrahim ◽  
John V Williams
Keyword(s):  
North America ◽  
Diagnostic Criteria ◽  
Skin Rash ◽  
Toxic Shock Syndrome ◽  
Disease Process ◽  
Toxic Shock ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
First Case

Abstract Neonatal toxic shock syndrome (TSS)-like exanthematous disease (NTED) is a syndrome first reported in Japan. Neonates develop systemic exanthema, thrombocytopenia, and fever usually during the first week of life. The disease is distinguished from frank TSS because affected infants are not severely ill and do not meet TSS criteria. Most infants are confirmed to be colonized with TSST-1 producing strains of S. aureus. Suggested diagnostic criteria for NTED include a skin rash with generalized macular erythema and one of the following symptoms: fever >38.0°C, thrombocytopenia <150 x103uL, or low positive C-reactive protein (1-5 mg/dL) in the absence of another known disease process. NTED is common in Japanese NICUs, but outside Japan, only one case has been reported in France. We describe the first case of NTED reported in North America.

scholarly journals Gastrointestinal Mucormycosis following aStreptococcus pyogenesToxic Shock Syndrome in a Previously Healthy Patient: A Case Report

2012 ◽  
Vol 2012 ◽  
pp. 1-6 ◽  
Author(s):  
Jean-François Roussy ◽  
Catherine Allard ◽  
Guy St-Germain ◽  
Jacques Pépin
Keyword(s):  
Case Report ◽  
Opportunistic Infection ◽  
Streptococcus Pyogenes ◽  
Toxic Shock Syndrome ◽  
Immunocompromised Patients ◽  
Healthy Patient ◽  
Toxic Shock ◽  
Rhizopus Microsporus ◽  
First Case ◽  
Rhizopus Sp

Mucormycosis is an uncommon opportunistic infection and the gastrointestinal form is the rarest.Rhizopus sp. is the most frequent pathogen and infection occurs almost exclusively in immunocompromised patients. We describe the first case of intestinal mucormycosis occurring after aStreptococcus pyogenestoxic shock syndrome in a previously healthy patient caused byRhizopus microsporusvar.azygosporus.

Toxic Shock

2018 ◽  
Author(s):  
Sharra L. Vostral
Keyword(s):  
Social History ◽  
Paradigm Shift ◽  
Mass Communication ◽  
Toxic Shock Syndrome ◽  
Large Scale ◽  
Product Liability ◽  
Disease Process ◽  
The United States ◽  
Toxic Shock ◽  
Primary Consumers

In 1980, young, healthy women in the United States suddenly began to get sick and even die. The unexpected link to these deaths was superabsorbent tampons. Thousands of women used them during their menstrual periods, signaling the potential for a large-scale outbreak. Toxic Shock: A Social History traces the emergence of this new illness of toxic shock syndrome (TSS) and its relationship to tampon technology. This multifaceted history engages microbiology, design and innovation, journalism and mass communication, product liability, and federal policy and regulation. The broad scope captures the various approaches that contributed to defining meaning about the emergent illness. Vostral argues that tampon-related TSS was a paradigm shift in the way that illness manifests. No longer was an infection necessarily the origin of disease, or a faulty product the direct cause of injury. Together, a new pathway to an illness formed, in which a supposedly inert tampon became interactive, and a bacterium once in equilibrium grew dominant and produced toxins. Toxic Shock: A Social History makes a case for understanding tampon-related TSS as the result of biocatalytic activity between technology and bacterium. Moreover, though women were the primary consumers of tampons, the bacterium became the unintended users. This unusual disease process challenged standard approaches to public health, required women to evaluate technological risk, and currently serves as a harbinger about other internal medical devices used and worn within the human body.

scholarly journals A Confirmed Case of Toxic Shock Syndrome Associated with the Use of a Menstrual Cup

2015 ◽  
Vol 26 (4) ◽  
pp. 218-220 ◽  
Author(s):  
Michael A Mitchell ◽  
Steve Bisch ◽  
Shannon Arntfield ◽  
Seyed M Hosseini-Moghaddam
Keyword(s):  
Health Risk ◽  
Present Article ◽  
Toxic Shock Syndrome ◽  
Cost Savings ◽  
Toxic Shock ◽  
First Case ◽  
First Time ◽  
Significant Health

Menstrual cups have been reported to be an acceptable substitute for tampons. These flexible cups have also been reported to provide a sustainable solution to menstrual management, with modest cost savings and no significant health risk.The present article documents the first case of toxic shock syndrome associated with the use of a menstrual cup in a woman 37 years of age, using a menstrual cup for the first time. Toxic shock syndrome and the literature on menstrual cups is reviewed and a possible mechanism for the development of toxic shock syndrome in the patient is described.

scholarly journals Uncommon cause of pelvic inflammatory disease leading to toxic shock syndrome

2018 ◽  
pp. bcr-2018-224955 ◽  
Author(s):  
Heather Lusby ◽  
Aaron Brooks ◽  
Eden Hamayoun ◽  
Amanda Finley
Keyword(s):  
Pelvic Inflammatory Disease ◽  
Inflammatory Disease ◽  
Toxic Shock Syndrome ◽  
Toxic Shock ◽  
Lower Quadrant ◽  
Reactive Protein ◽  
Source Of Infection ◽  
Intravenous Antibiotics ◽  
History Of ◽  
Group A

A 44-year-old Caucasian female with a history of endometriosis is admitted to the intensive care unit due to severe left lower quadrant abdominal pain, nausea and vomiting. With patients’ positive chandelier sign on pelvic examination, leucocytosis, elevated erythrocyte sedimentation rate and elevated C-reactive protein indicated that she had pelvic inflammatory disease (PID). PCR tests were negative for Neisseria gonorrhoeae and Chlamydia trachomatis; however, her blood and urine cultures grew Group A streptococci (GAS) with a negative rapid Streptococcus throat swab and no known exposure to Streptococcus. On further review, patient met criteria for GAS toxic shock syndrome based on diagnostic guidelines. The patient was promptly treated with intravenous antibiotics and supportive care, and she acutely recovered. This case demonstrates a rare cause of PID and an atypical aetiology of severe sepsis. It illuminates the importance of considering PID as a source of infection for undifferentiated bacteraemia.

scholarly journals A case of thyrotoxicosis-induced anemia in a patient with painless thyroiditis

2021 ◽  
Vol 14 (1) ◽  
Author(s):  
Ichiro Komiya ◽  
Takeaki Tomoyose ◽  
Noriharu Yagi ◽  
Gen Ouchi ◽  
Tamio Wakugami
Keyword(s):  
Reference Range ◽  
Disease Onset ◽  
C Reactive Protein ◽  
Free Triiodothyronine ◽  
Case Presentation ◽  
Reactive Protein ◽  
First Case ◽  
Silent Thyroiditis ◽  
Painless Thyroiditis ◽  
Mild Hypothyroidism

Abstract Background There have been several reports of secondary anemia associated with Graves’ disease. There are no reports of secondary anemia resulting from thyrotoxicosis due to painless thyroiditis (silent thyroiditis). We report the case of a patient with pancreatic diabetes who developed anemia caused by thyrotoxicosis due to painless thyroiditis. Case presentation The patient was a 37-year-old man who visited the hospital complaining of fatigue, palpitations, and dyspnea. His hemoglobin was 110 g/l (reference range, 135–176), and mean corpuscular volume was 81.5 fl (81.7–101.6). His free thyroxine (FT4) was high, at 100.4 pmol/l (11.6–21.9); the free triiodothyronine (FT3) was high, at 27.49 pmol/l (3.53–6.14); TSH was low, at < 0.01 mIU/l (0.50–5.00); and TSH receptor antibody was negative. Soluble IL-2 receptor (sIL-2R) was high, at 1340 U/ml (122–496); C-reactive protein (CRP) was high, at 6900 μg/l (< 3000); and reticulocytes was high, at 108 109 /l (30–100). Serum iron (Fe) was 9.5 (9.1–35.5), ferritin was 389 μg/l (13–401), haptoglobin was 0.66 g/l (0.19–1.70. Propranolol was prescribed and followed up. Anemia completely disappeared by 12 weeks after disease onset. Thyroid hormones and sIL-2R had normalized by 16 weeks after onset. He developed mild hypothyroidism and was treated with L-thyroxine at 24 weeks. Conclusions This is the first case report of transient secondary anemia associated with thyrotoxicosis due to painless thyroiditis. The change in sIL-2R was also observed during the clinical course of thyrotoxicosis and anemia, suggesting the immune processes in thyroid gland and bone marrow.

scholarly journals Criteria for Differentiation of Non-Bacterial and Haematogenous Osteomyelitis: A Case-Control Study With Prospective Verification of the Outcomes

2019 ◽  
Vol 17 (6) ◽  
pp. 458-464
Author(s):  
Mikhail M. Kostik ◽  
Olga L. Kopchak ◽  
Alexey I. Taschilkin ◽  
Vyacheslav I. Zorin ◽  
Alexey S. Maletin ◽  
...  
Keyword(s):  
Diagnostic Criteria ◽  
Clinical Symptoms ◽  
Laboratory Data ◽  
Disease Onset ◽  
Diagnostic Errors ◽  
Bone Destruction ◽  
Diagnostic Value ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Haematogenous Osteomyelitis

Background. Patients with haematogenous and non-bacterial osteomyelitis have similar clinical symptoms (pain in the nidus area, soft tissue swelling, fever) and laboratory signs (increased erythrocyte sedimentation rate, leukocyte count, C-reactive protein concentration). The criteria for distinguishing these two states are not determined.Objective. Our aim was to determine diagnostic criteria to differentiate haematogenous and non-bacterial osteomyelitis.Methods. The study included data of patients under the age of 18 years with non-bacterial or haematogenous osteomyelitis hospitalised to two clinical centres from 2009 to 2016. The diagnosis was established and re-verified according to archival data (medical history) and after two years of observation (at least once a year). Clinical, anamnestic and laboratory data (haemoglobin, leukocytes, leukocyte formula, platelets, ESR and C-reactive protein, CRP) as well as the results of radiation diagnostics (X-ray, CT scan, MRI or osteosyntigraphy) obtained at the disease onset were taken into account as potential diagnostic criteria.Results. Out of 145 patients with non-bacterial or haematogenous osteomyelitis, the diagnosis was re-verified in 138, of them non-bacterial osteomyelitis — in 91, haematogenous osteomyelitis — in 47. The following criteria had the highest diagnostic value for establishing cases of non-bacterial osteomyelitis: detection of bone destruction foci surrounded by osteosclerosis area [sensitivity (Se) 1.0; specificity (Sp) 0.79]; absence of fever (Se 0.66; Sp 0.92); the number of bone destruction foci > 1 (Se 0.73; Sp 1.0); CRP 55 mg/L (Se 0.94; Sp 0.73); negative results of bacteriological examination of the material from the bone destruction focus (Se 1.0; Sp 0.67).Conclusion. Diagnostic criteria for differentiation of non-bacterial and haematogenous osteomyelitis have been described. Further research on the efficacy of using these criteria to reduce the risk of diagnostic errors, decrease the diagnostic pause, reduce the risk of non-bacterial osteomyelitis complications is needed.

scholarly journals Infective Endocarditis Associated with Streptococcal Toxic Shock Syndrome due to Streptococcus dysgalactiae subsp. equisimilis Infection in a Hemodialysis Patient

2017 ◽  
Vol 7 (3) ◽  
pp. 154-160
Author(s):  
Momoko Kan ◽  
Yasukiyo Mori ◽  
Nao Kishimoto ◽  
Hiroki Shibutani ◽  
Yuno Tomita ◽  
...  
Keyword(s):  
Infective Endocarditis ◽  
General Population ◽  
Toxic Shock Syndrome ◽  
Hemodialysis Patient ◽  
Hemodialysis Patients ◽  
Chronic Hemodialysis ◽  
Streptococcal Toxic Shock Syndrome ◽  
Streptococcus Dysgalactiae ◽  
Toxic Shock ◽  
First Case

The risk of infective endocarditis in chronic hemodialysis patients is markedly higher than that in the general population. We report the first case of a hemodialysis patient with infective endocarditis caused by Streptococcus dysgalactiae subsp. equisimilis (SDSE) who presented with streptococcal toxic shock syndrome. In the last decade, there has been an increase in the incidence of SDSE infections. Therefore, it is important to recognize SDSE as a possible causative agent of infective endocarditis in an immunocompromised population, such as hemodialysis patients.

First Experience on Bilirubin Removal with a Hemoadsorption Column (Lixelle®) in a Child with Cardiogenic Liver Injury

2017 ◽  
Vol 40 (9) ◽  
pp. 522-525 ◽  
Author(s):  
Gabriella Bottari ◽  
Andrea Moscatelli ◽  
Enrico E. Verrina ◽  
Franco Lerzo ◽  
Fabio S. Taccone
Keyword(s):  
Liver Injury ◽  
Potential Role ◽  
C Reactive Protein ◽  
Progressive Reduction ◽  
Reactive Protein ◽  
Persistent Inflammation ◽  
First Case ◽  
Congestive Liver ◽  
Severe Hyperbilirubinemia

Introduction Hyperbilirubinemia may have deleterious effects on many organs, even after the neonatal age. Blood purification is effective in the treatment of hyperbilirubinemia. Recently some reports suggest the potential role of hemoadsorption columns in this setting. Methods We present the case of a 6-year-old child with severe hyperbilirubinemia due to congestive liver dysfunction, complicated by persistent inflammation, immunosuppression and catabolism syndrome (PICS). The patient was treated with a hemoadsorption column (Lixelle®) in combination with continuous veno-venous hemodiafiltration (CVVHDF). Results During treatment, a significant and rapid decrease in total bilirubin (TB) and other indices of cholestasis was observed. Furthermore, a progressive reduction in the inflammatory biomarkers (Procalcitonin, C-reactive protein) occurred. These results persisted at the discontinuation of therapy. Conclusions To our knowledge this is the first case in which hemoadsorption with the Lixelle® adsorbing column in combination with CVVHDF has been used to manage pediatric hyperbiliribinemia secondary to cardiogenic liver injury.

scholarly journals Inhibiting C-Reactive Protein for the Treatment of Cardiovascular Disease: Promising Evidence from Rodent Models

2014 ◽  
Vol 2014 ◽  
pp. 1-9 ◽  
Author(s):  
Alexander J. Szalai ◽  
Mark A. McCrory ◽  
Dongqi Xing ◽  
Fadi G. Hage ◽  
Andrew Miller ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Heart Function ◽  
Controlled Trial ◽  
Disease Process ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Cardiovascular Damage ◽  
A Prospective Study ◽  
Control Study

Raised blood C-reactive protein (CRP) level is a predictor of cardiovascular events, but whether blood CRP is causal in the disease process is unknown. The latter would best be defined by pharmacological inhibition of the protein in the context of a randomized case-control study. However, no CRP specific drug is currently available so such a prospective study cannot be performed. Blood CRP is synthesized primarily in the liver and the liver is an organ where antisense oligonucleotide (ASO) drugs accumulate. Taking advantage of this we evaluated the efficacy of CRP specific ASOs in rodents with experimentally induced cardiovascular damage. Treating rats for 4 weeks with a rat CRP-specific ASO achieved >60% reduction of blood CRP. Notably, this effect was associated with improved heart function and pathology following myocardial infarction (induced by ligation of the left anterior descending artery). Likewise in human CRP transgenic mice treated for 2 weeks with a human CRP-specific ASO, blood human CRP was reduced by >70% and carotid artery patency was improved (2 weeks after surgical ligation). CRP specific ASOs might pave the way towards a placebo-controlled trial that could clarify the role of CRP in cardiovascular disease.

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