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[Toxic shock-like syndrome caused by streptococci]
J T van Dissel1, B J Kullberg, J W van der Meer
1Leids Universitair Medisch Centrum, afd. Infectieziekten, Leiden.
Nederlands Tijdschrift Voor Geneeskunde
|August 12, 1999
Summary
Group A Streptococcus (GAS) infections, including toxic shock syndrome (STSS), are increasing globally in adults. Current treatments have high mortality, and optimal antibiotic choices and new therapies require further investigation.
Area of Science:
- Microbiology
- Infectious Diseases
- Toxicology
Context:
- Global increase in severe invasive group A streptococci (GAS) infections since the mid-1980s.
- GAS infections affect not only the elderly but also healthy adults.
- Streptococcal toxic shock syndrome (STSS) presents acutely with fever, erythema, shock, and multiorgan failure.
Purpose:
- To review the current understanding of invasive group A streptococci (GAS) infections and streptococcal toxic shock syndrome (STSS).
- To highlight the high mortality rates associated with STSS despite existing treatments.
- To identify gaps in knowledge regarding optimal antibiotic selection and novel therapeutic strategies.
Summary:
- Invasive group A streptococci (GAS) infections and STSS are a growing global health concern.
- Standard treatments including surgery, penicillin, and clindamycin show high mortality rates in STSS patients.
- Limited data exist to guide the choice between penicillin and clindamycin for STSS.
- The efficacy of high-dose intravenous immunoglobulin (IVIG) for neutralizing exotoxins in STSS remains unproven.
Impact:
- Highlights the urgent need for improved treatment strategies for STSS.
- Underscores the importance of further research into antibiotic efficacy and adjunctive therapies like IVIG.
- Emphasizes the rising threat of invasive GAS infections in diverse populations worldwide.