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Necrotizing proctitis caused by Streptococcus pyogenes

M Barnham1, A K Al-Dabbagh, C Gray

  • 1Department of Microbiology, Harrogate District Hospital, North Yorkshire, UK.

The Journal of Infection
|July 25, 2000
PubMed

Insights

This case study describes a rare instance of Streptococcus pyogenes causing necrotizing proctitis, leading to severe illness including peritonitis and toxic shock syndrome. The patient ultimately recovered after intensive treatment and surgery.

Area of Science:

  • Infectious Diseases
  • Gastroenterology
  • Surgical Pathology

Background:

  • Peritonitis, septicaemia, and toxic shock syndrome are severe conditions often requiring intensive care.
  • Acute purulent proctitis is inflammation of the rectum, which can lead to serious complications if untreated.

Observation:

  • A 65-year-old patient presented with symptoms of peritonitis, septicaemia, and toxic shock syndrome.
  • The primary source of infection was identified as acute purulent proctitis with necrosis.
  • Streptococcus pyogenes serotype T28R28 was isolated from blood and peritoneal pus samples.

Findings:

  • The patient underwent four abdominal operations, including anterior resection of the rectum.
  • Recovery was achieved after an extended period of intensive therapy.
  • This case represents the first clinical description of streptococcal necrotizing proctitis.

Implications:

  • Highlights the potential for Streptococcus pyogenes to cause severe rectal infections.
  • Emphasizes the importance of considering proctitis as a primary focus in severe systemic infections.
  • Underscores the need for prompt diagnosis and aggressive management of necrotizing proctitis.

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