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.

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.

scholarly journals Streptococcus pyogenes sukeltas nekrozinis fascitas po uždaro šokikaulio išnirimo

2008 ◽  
Vol 6 (4) ◽  
pp. 0-0
Author(s):  
Valentinas Uvarovas ◽  
Igoris Šatkauskas ◽  
Tomas Sveikata ◽  
Eduardas Bartkevičius
Keyword(s):  
Emergency Department ◽  
Streptococcus Pyogenes ◽  
Toxic Shock Syndrome ◽  
Plaster Cast ◽  
Streptococcal Toxic Shock Syndrome ◽  
Toxic Shock ◽  
Group A ◽  
Necrotizing Fascitis ◽  
Vilnius University ◽  
The Right

Valentinas Uvarovas, Igoris Šatkauskas, Tomas Sveikata, Eduardas BartkevičiusVilniaus greitosios pagalbos universitetinės ligoninės Ortopedijos ir traumatologijos centras,Šiltnamių g. 29, LT-04130 VilniusEl paštas: [email protected] Šio straipsnio tikslas – aparašyti nekrozinio fascito klinikinį atvejį, pateikti literatūros apžvalgą. Nekrozinis fascitas – gyvybei pavojinga labai greitai plintanti infekcija, kuri audiniuose gali plisti žaibišku greičiu. Ji sukelia didelį mirštamumą (miršta nuo 24% iki 40% ligonių) [1, 2] bei didelį traumatizmą. Nekrozinis fascitas apima paviršines fascijas, poodinius riebalus, nervus, venas, arterijas, giliąsias fascijas. Patofiziologiškai infekcija pasireiškia fibrinoidine arteriolių koaguliacija, kuri sukelia audinių išemiją ir nekrozę.Aprašomas klinikinis atvejis, kai 44 metų pacientei uždaras kulnakaulio išnirimas komplikavosi nekrotiziniu fascitu ir streptokokiniu sepsiniu šoku su dauginiu organų nepakankamumu. Klinika pasireiškė šeštą parą po traumos, pacientė kreipėsi pakartotinai į skubiosios traumatologinės pagalbos skyrių dėl stipraus čiurnos srities skausmo. Nekrozinis fascitas ir sepsinis šokas diagnozuotas po 36 val., kai buvo paguldyta į ligoninę: skausmas išplito iki šlaunies, atsirado pūslių blauzdoje ir šlaunyje. Pacientė operuota kelis kartus: atliktos fasciotomijos, nekrektomijos, žaizdų revizija, amputuota galūnė, vėliau dėl plaštakų ir kitos pėdos gangrenavimo atliktos likusių galūnių amputacijos. Pacientė dėl sepsinio šoko ir dauginio organų nepakankamumo gydyta intensyviosios terapijos skyriuje, hemodinamika buvo palaikoma didelėmis vazopresorių dozėmis, taikyta antibiotikų terapija, hemofiltracija. Pagrindinis ligos sukėlėjas – Streptococcus pyogenes. Ligonė išgyveno, bet liko neįgali. Prognozė priklauso nuo laiku atlikto ir radikalaus chirurginio gydymo. Ankstyva diagnostika ir standartizuotas gydymas pagerintų nekrozinio fascito gydymo rezultatus vertinant mirtingumą ir galūnių išsaugojimą. Reikšminiai žodžiai: nekrozinis fascitas, Streptococcus pyogenes, toksinis šokas Streptococcus pyogenes necrotizing fascitis after closed calcaneus luxation Valentinas Uvarovas, Igoris Šatkauskas, Tomas Sveikata, Eduardas BartkevičiusOrthopedic Traumatology Center of Vilnius University Emergency Hospital,Šiltnamių str. 29, LT-04130 Vilnius, LithuaniaE-mail: [email protected] The aim of this study was to present a rare case of necrotizing fascitis and review the literature. We report a case of a 44-year-old female patient with a right closed subtalar luxation whose treatment developed necrotizing fascitis, streptococcal toxic shock syndrome and ended up with amputation of four limbs. After closed reduction of the calcaneus and immobilization in plaster cast at our emergency department and 2 days of hospitalization, the patient was referred for outpatient care. Within 6 days, due to severe pain and moderate swelling of the right ankle joint and the calf, the patient was admitted to the emergency department for the second time. In 36 hours after hospitalization, the patient developed hypotension and a severe septic situation with progressive swelling of the right calf and thigh. After the diagnosis of necrotizing fascitis had been established, the patient underwent an urgent and aggressive surgical debridement with fasciotomies of the right lower extremity. The microbiological investigation of the intraoperatively taken specimens presented group A-ß-hemolytic streptococcus. The patient survived, but despite an antibiotic therapy, intensive care support and second book operation, the amputation of the right leg was done, and the treatment ended in the amputation of the left tibia and both arms. Key words: necrotizing fascitis, Streptococcus pyogenes, 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.

scholarly journals Staphylococcal Toxic Shock Syndrome Complicating Influenza A Infection in a Young Child

2011 ◽  
Vol 2011 ◽  
pp. 1-3 ◽  
Author(s):  
Timothy R. Peters ◽  
Dudley E. Hammon ◽  
Rima J. Jarrah ◽  
Elizabeth L. Palavecino ◽  
Elizabeth S. Blakeney ◽  
...  
Keyword(s):  
Toxic Shock Syndrome ◽  
Influenza A ◽  
Bacterial Culture ◽  
Rare Complication ◽  
Influenza Infection ◽  
Tracheal Aspirate ◽  
Upper Respiratory Tract ◽  
Toxic Shock ◽  
Upper Respiratory ◽  
Staphylococcal Toxic Shock Syndrome

Toxic shock syndrome (TSS) is a potentially lethal but rare complication of influenza infection. We report a case of TSS and influenza A infection in a 5-year-old boy without respiratory symptoms, in whom tracheal aspirate bacterial culture grew a toxin-producing strain of Staphylococcus aureus. Bacterial culture of the upper respiratory tract should be considered in patients with influenza-associated toxic shock syndrome.

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.

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