scholarly journals A case report of streptococcal toxic shock syndrome caused by Streptococcus mitis in a healthy adult

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Xiang Chen ◽  
Ying Ying Gong ◽  
Li Zhang
Keyword(s):  
Septic Shock ◽  
Mortality Rate ◽  
Fluid Resuscitation ◽  
Toxic Shock Syndrome ◽  
Group A Streptococcus ◽  
Vital Signs ◽  
Streptococcal Toxic Shock Syndrome ◽  
Toxic Shock ◽  
Streptococcus Mitis ◽  
Aggressive Fluid Resuscitation

Abstract Background Streptococcal toxic shock syndrome (STSS) is an acute, multisystem and toxin-mediated disease that usually causes shock and multiple organ failure in the early stages of its clinical course. It is associated with a substantial increase in mortality rate. The disease has been associated with invasive group A Streptococcus and is rarely caused by Streptococcus mitis (S. mitis). In healthy adults, S. mitis is closely related to endocarditis but rarely related to STSS. Case presentation We report a case of STSS caused by S. mitis in a healthy 45-year-old woman. She presented with fever 14 h after surgery and with hypotension 24 h later, and she subsequently suffered from septic shock, low albumin, dysfunction of coagulation, acute kidney dysfunction, respiratory alkalosis and metabolic acidosis, acute respiratory distress syndrome and cellulitis of the incision. The diagnosis was obtained through clinical manifestation and blood culture examination. The patient was treated with aggressive fluid resuscitation, adequate antibiotics for a total of 4 weeks, respiratory support, and surgical debridement and drainage of the incision. She was discharged after her vital signs returned to normal and the incision healed on day 40 after surgery. Conclusions The diagnosis of STSS is often delayed or missed, which leads to a high mortality rate. It is possible to cure patients if the disease can be identified early and treated with aggressive fluid resuscitation, adequate antibiotics and control of the source of infection. Clinicians should consider the disease in the differential diagnosis of septic shock to prevent death.

scholarly journals Group A Streptococcal Toxic Shock Syndrome after a Routine Gynecological Procedure

2021 ◽  
Vol 2021 ◽  
pp. 1-5
Author(s):  
Kei Ameda ◽  
Yoko Yamada ◽  
Yuriko Uehara ◽  
Tamami Ohno ◽  
Mari Hoya ◽  
...  
Keyword(s):  
Septic Shock ◽  
Toxic Shock Syndrome ◽  
Vaginal Discharge ◽  
Group A Streptococcus ◽  
Vaginal Swab ◽  
Streptococcal Toxic Shock Syndrome ◽  
Toxic Shock ◽  
Primary Peritonitis ◽  
Gynecological Examination ◽  
Group A

Streptococcal toxic shock syndrome (STSS) is a life-threatening illness mainly caused by invasive group A Streptococcus (GAS) infection. Herein, we report a case of a postmenopausal woman who developed STSS from an ascending vaginal GAS infection after cytocervical sampling. The patient complained of vaginal discharge, for which she underwent gynecological examination with vaginal sampling. The following day, there was onset of diarrhea and vomiting. After 7 days, she was admitted to our hospital with septic shock. Necrotizing enterocolitis was suspected and surgical intervention was performed; however, the patient was diagnosed with primary peritonitis and antibiotics were initiated. On day 2, GAS was suspected by blood cultures, and antibiotics were changed in consideration of STSS. On day 4, GAS was confirmed in blood, ascitic fluid, and vaginal swab specimens, and STSS caused by an ascending vaginal GAS infection was diagnosed. This case report indicates that STSS could occur following cytocervical sampling for vaginal discharge. If a woman has unexplained septic shock, especially with gastroenteritis symptoms, STSS should be considered as a differential diagnosis.

scholarly journals Streptococcal sepsis and periorbital cellulitis as a complication of influenza in a 4-year-old girl

2020 ◽  
Vol 16 (3) ◽  
pp. 312-315
Author(s):  
Anna Materny ◽  
◽  
Ernest Kuchar ◽  
Keyword(s):  
Toxic Shock Syndrome ◽  
Influenza A ◽  
Bacterial Infections ◽  
Group A Streptococcus ◽  
Rare Complication ◽  
Fatal Outcome ◽  
Systemic Infection ◽  
Streptococcal Toxic Shock Syndrome ◽  
Toxic Shock ◽  
The Right

Influenza may pave the way for some specific bacterial infections. In this case study we present a rare complication of influenza A infection – periorbital cellulitis followed by streptococcal toxic shock syndrome and scarlet fever. A 4-year-old otherwise healthy girl presented with her mother to a general practitioner with fatigue, irritability and fever not responding to antipyretics. Due to the positive rapid influenza diagnostic test, treatment with oseltamivir was implemented. The Quick Strep Test was negative. During the following days, the patient’s condition worsened, leading to an admission to a paediatric otolaryngology unit. Doctors observed an asymmetrical swelling of the lids with exophthalmos of the right eye, pharyngitis, petechiae in skin folds, a strawberry tongue and skin exfoliation on the lips. The patient was treated with intravenous broadspectrum antibiotics (cefotaxime, vancomycin) and underwent drainage of sinuses, without any significant improvement. On the following day, the girl showed signs of systemic infection, confusion and further swelling of both eyes, and therefore was moved to an intensive care unit. Computed tomography of the head showed signs of periorbital cellulitis with destruction of the surrounding bones. After obtaining a positive blood culture for group A streptococcus, penicillin and clindamycin were immediately administered. The patient’s condition improved within 24 hours. The described case emphasises the importance of yearly influenza vaccination, especially in the groups with risk factors like very young age. Early diagnosis of the streptococcal infection as a complication of influenza and a targeted treatment may prevent the potentially fatal outcome in the form of streptococcal toxic shock syndrome.

scholarly journals AR-12 Has a Bactericidal Activity and a Synergistic Effect with Gentamicin against Group A Streptococcus

2021 ◽  
Vol 22 (21) ◽  
pp. 11617
Author(s):  
Nina Tsao ◽  
Ya-Chu Chang ◽  
Sung-Yuan Hsieh ◽  
Tang-Chi Li ◽  
Ching-Chen Chiu ◽  
...  
Keyword(s):  
Toxic Shock Syndrome ◽  
Group A Streptococcus ◽  
Streptococcal Toxic Shock Syndrome ◽  
Invasive Infection ◽  
Toxic Shock ◽  
Spherical Structures ◽  
Group A ◽  
Bacteria And Fungi

Streptococcus pyogenes (group A Streptococcus (GAS) is an important human pathogen that can cause severe invasive infection, such as necrotizing fasciitis and streptococcal toxic shock syndrome. The mortality rate of streptococcal toxic shock syndrome ranges from 20% to 50% in spite of antibiotics administration. AR-12, a pyrazole derivative, has been reported to inhibit the infection of viruses, intracellular bacteria, and fungi. In this report, we evaluated the bactericidal activities and mechanisms of AR-12 on GAS infection. Our in vitro results showed that AR-12 dose-dependently reduced the GAS growth, and 2.5 μg/mL of AR-12 significantly killed GAS within 2 h. AR-12 caused a remarkable reduction in nucleic acid and protein content of GAS. The expression of heat shock protein DnaK and streptococcal exotoxins was also inhibited by AR-12. Surveys of the GAS architecture by scanning electron microscopy revealed that AR-12-treated GAS displayed incomplete septa and micro-spherical structures protruding out of cell walls. Moreover, the combination of AR-12 and gentamicin had a synergistic antibacterial activity against GAS replication for both in vitro and in vivo infection. Taken together, these novel findings obtained in this study may provide a new therapeutic strategy for invasive GAS infection.

Streptococcal toxic shock syndrome secondary to group A Streptococcus vaginitis

2015 ◽  
Vol 21 (12) ◽  
pp. 873-876 ◽  
Author(s):  
Mayu Hikone ◽  
Ken-ichiro Kobayashi ◽  
Takuya Washino ◽  
Masayuki Ota ◽  
Naoya Sakamoto ◽  
...  
Keyword(s):  
Toxic Shock Syndrome ◽  
Group A Streptococcus ◽  
Streptococcal Toxic Shock Syndrome ◽  
Toxic Shock ◽  
Group A

Group A Streptococcus and hepatitis – streptococcal toxic shock syndrome

2015 ◽  
Vol 04 (03) ◽  
pp. 295-299
Author(s):  
Sanjeev Gupta ◽  
Jarrod Brumby ◽  
Joanna Burton ◽  
Susan Moloney ◽  
Benjamin Kenny
Keyword(s):  
Toxic Shock Syndrome ◽  
Group A Streptococcus ◽  
Streptococcal Toxic Shock Syndrome ◽  
Toxic Shock ◽  
Group A

Challenges in Surveillance for Streptococcal Toxic Shock Syndrome: Active Bacterial Core Surveillance, United States, 2014-2017

2021 ◽  
pp. 003335492110134
Author(s):  
Srinivas Acharya Nanduri ◽  
Jennifer Onukwube ◽  
Mirasol Apostol ◽  
Nisha Alden ◽  
Susan Petit ◽  
...  
Keyword(s):  
Toxic Shock Syndrome ◽  
Group A Streptococcus ◽  
Population Based ◽  
Streptococcal Toxic Shock Syndrome ◽  
Toxic Shock ◽  
Clinical Criteria ◽  
True Incidence ◽  
Active Population ◽  
Routine Surveillance ◽  
Routine Identification

Objectives Routine surveillance for streptococcal toxic shock syndrome (STSS), a severe manifestation of invasive group A Streptococcus (GAS) infections, likely underestimates its true incidence. The objective of our study was to evaluate routine identification of STSS in a national surveillance system for invasive GAS infections. Methods Active Bacterial Core surveillance (ABCs) conducts active population-based surveillance for invasive GAS disease in selected US counties in 10 states. We categorized invasive GAS cases with a diagnosis of STSS made by a physician as STSS–physician and cases that met the Council of State and Territorial Epidemiologists (CSTE) clinical criteria for STSS based on data in the medical record as STSS–CSTE. We evaluated agreement between the 2 methods for identifying STSS and compared the estimated national incidence of STSS when applying proportions of STSS–CSTE and STSS–physician among invasive GAS cases from this study with national invasive GAS estimates for 2017. Results During 2014-2017, of 7572 invasive GAS cases in ABCs, we identified 1094 (14.4%) as STSS–CSTE and 203 (2.7%) as STSS–physician, a 5.3-fold difference. Of 1094 STSS–CSTE cases, we identified only 132 (12.1%) as STSS–physician cases. Agreement between the 2 methods for identifying STSS was low (κ = 0.17; 95% CI, 0.14-0.19). Using ABCs data, we estimated 591 cases of STSS–physician and 3618 cases of STSS–CSTE occurred nationally in 2017. Conclusions We found a large difference in estimates of incidence of STSS when applying different surveillance methods and definitions. These results should help with better use of currently available surveillance data to estimate the incidence of STSS and to evaluate disease prevention efforts, in addition to guiding future surveillance efforts for STSS.

Streptococcal Toxic Shock Syndrome Revealed by a Peritonitis

Swiss Surgery ◽  
2001 ◽  
Vol 7 (1) ◽  
pp. 25-27 ◽  
Author(s):  
Vuilleumier ◽  
Halkic
Keyword(s):  
Toxic Shock Syndrome ◽  
Group A Streptococcus ◽  
Early Recognition ◽  
Post Partum ◽  
Fatal Outcome ◽  
Purpura Fulminans ◽  
Infectious Complications ◽  
Streptococcal Toxic Shock Syndrome ◽  
Toxic Shock ◽  
Life Threatening

Group A streptococcus (GAS) or Streptococcus pyogenes cause a variety of life-threatening infectious complications including necrotizing fasciitis, purpura fulminans and streptococcal toxic shock syndrome (STSS). Exotoxins that act as superantigens are felt to be responsible for STSS. These exotoxins are highly destructive to skin, muscle and soft tissue. This syndrome has a rapid and fulminant course with frequently fatal outcome. GAS remains sensitive to penicillin but in serious infection a combination of clindamycin and ceftriaxone or meropenemum is recommended. Several studies have shown that mortality was dramatically reduced in STSS patients treated with immunoglobulin G given intravenously (IVIG). Early recognition of this most rapidly progressive infection and prompt operative debridement are required for successful management. This report presents a female patient at two month post-partum with a peritonitis and multi-organ failure.

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