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

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.

scholarly journals Group a streptococcal cellulitis in the early puerperium

2011 ◽  
Vol 68 (7) ◽  
pp. 607-610
Author(s):  
Branka Nikolic ◽  
Ana Mitrovic ◽  
Svetlana Dragojevic-Dikic ◽  
Snezana Rakic ◽  
Zlatica Cakic ◽  
...  
Keyword(s):  
Case Report ◽  
Toxic Shock Syndrome ◽  
Early Recognition ◽  
Healthy Woman ◽  
Supportive Therapy ◽  
Streptococcal Toxic Shock Syndrome ◽  
Toxic Shock ◽  
Short Period ◽  
History Of ◽  
Group A

Introduction. Infectious diseases caused by Streptococcus pyogenes, a member of the group A Streptococci (GAS) are among the most common life threatening ones. Patients with GAS infections have a poor survival rate. Cellulitis is a severe invasive GAS infection and the most common clinical presentation of the disease associated with more deaths than it can be seen in other GAS infections. According to the literature data, most cases of GAS toxic shock syndrome are developed in the puerperium. However, there are two main problems with GAS infection in early puerperium and this case report is aimed at reminding on them. The first problem is an absence of awareness that it can be postpartal invasive GAS infection before the microbiology laboratory confirms it, and the second one is that we have little knowledge about GAS infection, in general. Case report. A 32- year-old healthy woman, gravida 1, para 1, was hospitalized three days after vaginal delivery with a 38-hour history of fever, pain in the left leg (under the knee), and head injury after short period of conscious lost. Clinical picture of GAS infection was cellulites. Group A Streptoccocus pyogenes was isolated in vaginal culture. Rapid antibiotic and supportive treatment stopped development of streptococcal toxic shock syndrome (STSS) and potential multiorganic failure. Signs and symptoms of the infection lasted 25 days, and complete recovery of the patient almost 50 days. Conclusion. In all women in childbed with a history of fever early after delivery, vaginal and cervical culture specimens should be taken as soon as possible. Early recognition of GAS infection in early puerperium and prompt initiation of antimicrobial drug and supportive therapy can prevent development of STSS and lethal outcome.

Streptococcal toxic shock syndrome revealed phlegmasia cerulea dolens of the arm

2020 ◽  
Vol 20 (11) ◽  
pp. 1348
Author(s):  
Vivien Moris ◽  
David Guillier ◽  
Narcisse Zwetyenga ◽  
Eric Steinmetz
Keyword(s):  
Toxic Shock Syndrome ◽  
Streptococcal Toxic Shock Syndrome ◽  
Toxic Shock ◽  
Phlegmasia Cerulea Dolens

scholarly journals A Patient of Using Presepsin to Diagnose Streptococcal Toxic Shock Syndrome during Anticancer Drug Treatment

2019 ◽  
Vol 2019 ◽  
pp. 1-5
Author(s):  
Gaku Takahashi
Keyword(s):  
Blood Culture ◽  
Toxic Shock Syndrome ◽  
Lower Leg ◽  
Rapid Progression ◽  
Streptococcal Toxic Shock Syndrome ◽  
Toxic Shock ◽  
Anticancer Chemotherapy ◽  
Successful Recovery ◽  
Short Period ◽  
Infection Focus

Background. Streptococcal toxic shock syndrome (STSS) is a rapidly progressive infection, with potentially rapid patient deterioration in a very short period. We experienced a rare case of STSS during anticancer chemotherapy, and we continuously measured presepsin (P-SEP) and evaluated its usefulness. Case Presentation. A 60-year-old woman with pulmonary metastasis from cervical cancer began anticancer chemotherapy. A fever of >40°C and right lower leg swelling developed on day 3. Symptoms worsened despite cefmetazole treatment (1.0 g/day). Blood culture was performed without suspecting STSS. On day 5, symptoms worsened and acute disseminated intravascular coagulation (DIC) and sequential organ failure assessment (SOFA) scores increased. C-reactive protein (CRP) increased from 28.8 mg/dl to 35.5 mg/dl and P-SEP also increased from 1,635 to 2,350 pg/mL. STSS was suspected due to the rapid progression of brown discoloration of the entire right lower leg. Ceftriaxone 2 g/day and clindamycin 1,200 mg/day were begun. On the evening of day 5, blood culture revealed rapidly progressive group A streptococci. After that, symptoms improved rapidly with treatment, and SOFA and DIC scores also decreased. While CRP remained at about 0.5 mg/dl, P-SEP remained slightly elevated at about 400 pg/mL. A residual infection focus was suspected. Contrast-enhanced computed tomography (CT) revealed a capsule-enclosed abscess in the right lower leg soleus muscle on day 32. Debridement was performed and antibiotics were continued until P-SEP was 88 pg/mL. CT confirmed the disappearance of the abscess. Conclusion. Prompt diagnosis by blood culture and a sufficiently early, appropriate change in antibiotic therapy led to successful recovery from STSS during anticancer chemotherapy without lower limb amputation. P-SEP was useful in assessment of the residual infection focus and suspending treatments.

scholarly journals Streptococcal toxic shock syndrome following total thyroidectomy

2013 ◽  
Vol 95 (7) ◽  
pp. 457-460 ◽  
Author(s):  
J AZ Hung ◽  
P Rajeev
Keyword(s):  
Total Thyroidectomy ◽  
Toxic Shock Syndrome ◽  
Cowden Syndrome ◽  
Streptococcal Toxic Shock Syndrome ◽  
Rare Occurrence ◽  
Toxic Shock ◽  
Group A ◽  
High Index Of Suspicion ◽  
Improve Patient ◽  
Management Issues

Group A streptococcal toxic shock syndrome following clean surgery is a rare occurrence. Its incidence following thyroid surgery has not been described in the literature. We report on the presentation and management of severe streptococcal toxic shock syndrome following a total thyroidectomy for a multinodular goitre in a patient with Cowden syndrome. This report presents an overview of streptococcal toxic shock syndrome with a focus on the management issues to consider so as to improve patient outcome. All surgeons must maintain a high index of suspicion for this rare but dangerous entity.

scholarly journals Capsule ofStreptococcus pyogenesIs Essential for Delayed Death of Mice in a Model of Streptococcal Toxic Shock Syndrome

2006 ◽  
Vol 50 (2) ◽  
pp. 127-130 ◽  
Author(s):  
Ken-ichiro Iida ◽  
Masanori Seki ◽  
Mitsumasa Saito ◽  
Yoshiaki Kawamura ◽  
Hideko Kajiwara ◽  
...  
Keyword(s):  
Toxic Shock Syndrome ◽  
Streptococcal Toxic Shock Syndrome ◽  
Toxic Shock ◽  
Delayed Death
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