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Recurrent sepsis caused by Streptococcus pyogenes

Magnus Rasmussen1

  • 1Department of Clinical Sciences, Division of Infection Medicine, BMC B14, Tornavägen 10, 221 84 Lund, Sweden. Magnus.Rasmussen@med.lu.se

Journal of Clinical Microbiology
|February 25, 2011
PubMed

Insights

Recurrent bacteremia with Streptococcus pyogenes is rare, especially in patients with atherosclerosis. This case highlights a potential link between foot ulcers and recurrent sepsis, with a lack of antibody response.

Area of Science:

  • Infectious Diseases
  • Immunology
  • Cardiovascular Medicine

Background:

  • Severe atherosclerosis poses significant health risks, often complicating infectious disease management.
  • Streptococcus pyogenes (Group A Strep) infections can lead to severe morbidity, including sepsis.
  • Recurrent episodes of bacteremia are uncommon, particularly with specific strains like emm87.

Observation:

  • A 75-year-old male patient with severe atherosclerosis presented with two distinct episodes of bacteremia.
  • Both bacteremic episodes were caused by Streptococcus pyogenes, specifically serotype emm87.
  • A chronic foot ulcer was identified as the probable portal of entry for the bacteria.

Findings:

  • The patient's immune system failed to produce opsonizing antibodies against the infecting Streptococcus pyogenes emm87 isolate.
  • This lack of antibody response may have contributed to the recurrent nature of the bacteremia.
  • The severe atherosclerosis might have impaired the host's immune response or increased susceptibility.

Implications:

  • This case underscores the importance of investigating underlying conditions, such as atherosclerosis and chronic wounds, in recurrent infections.
  • Understanding the immune response, or lack thereof, to specific bacterial strains is crucial for managing recurrent sepsis.
  • Further research into host-pathogen interactions in immunocompromised or comorbid patients is warranted.

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