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[2 cases of severe Streptococcus group A infection]
Lakartidningen
|October 25, 1989
Summary
Severe Group A Streptococcus (GAS) infections can be fatal. This study highlights successful adjuvant treatments, including plasma exchange and immunoglobulin therapy, for patients with GAS sepsis and multiple organ failure.
Area of Science:
- Infectious Diseases
- Critical Care Medicine
- Hematology
Background:
- Group A Streptococcus (GAS) infections can lead to severe, life-threatening conditions.
- Sepsis and septic shock caused by GAS present significant challenges in critical care.
- Understanding the clinical manifestations and treatment responses in severe GAS infections is crucial.
Observation:
- Two patients with severe GAS infections, one in preshock and one in septic shock, exhibited coagulopathy and multi-organ dysfunction.
- Clinical signs included rash, relative bradycardia, edema, and impaired lung, kidney, and brain function.
- Both patients lacked antibodies against predominant GAS toxins B and C.
Findings:
- Initial management involved fluids, antibiotics, antithrombin, and hydrocortisone.
- Plasma exchange and, in one case, immunoglobulin therapy were administered as adjuvant treatments.
- Both patients with severe GAS infections and organ failure ultimately recovered.
Implications:
- Adjuvant therapies, such as plasma exchange and immunoglobulin, may be beneficial when conventional treatments for severe GAS sepsis fail.
- Early and aggressive management, including supportive care and novel therapeutic strategies, can improve outcomes in critical GAS infections.
- Further research into the role of toxin neutralization and immune support in GAS sepsis is warranted.