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Fulminant liver failure in a child with invasive group A streptococcal infection

M-N Biesel-Desthieux1, P Tissières, D C Belli

  • 1Department of Pediatrics and Pediatric Surgery, University Hospital of Geneva, 1211 Geneva 14, Switzerland.

European Journal of Pediatrics
|March 21, 2003
PubMed
Abstract

Insights

Group A streptococcal infection can cause fulminant liver failure (FLF) in children. Early antibiotics are crucial for recovery, even without shock, as suggested by this case report.

Area of Science:

  • Pediatric Infectious Diseases
  • Hepatology

Background:

  • Fulminant liver failure (FLF) is a rare but severe condition in children.
  • Liver involvement is recognized in streptococcal toxic shock syndrome, but FLF is not a typical presentation.

Observation:

  • A 2-year-old child presented with isolated FLF.
  • The FLF was secondary to an invasive group A streptococcal infection.
  • The causative strain was M1T1 type, expressing speA, speB, and speC toxin genes, and the child did not present with shock.

Findings:

  • The child recovered rapidly following antibiotic treatment.
  • No liver transplantation was required for recovery.

Implications:

  • Streptococcal pyrogenic exotoxins are implicated as the cause of FLF.
  • This etiology should be considered in the differential diagnosis of pediatric FLF.
  • Early antibiotic administration is recommended for invasive streptococcal infections presenting with FLF.

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