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Neutropenia and T-Wave Inversion as Toxin-Mediated Complications of a Streptococcal Infection

Cristina Popescu1,2, Anca Leuştean1,2, Alina Elena Orfanu1,2

  • 1"Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania.

Journal of Critical Care Medicine (Universitatea De Medicina Si Farmacie Din Targu-Mures)
|July 4, 2018
PubMed
Abstract

Insights

Toxin-mediated complications (TMC) from streptococcal infections can manifest early, even with initial negative tests. Prompt treatment with antibiotics and steroids rapidly resolved severe symptoms and ECG abnormalities in a young woman.

Area of Science:

  • Infectious Diseases
  • Cardiology
  • Toxicology

Background:

  • Streptococcal infections can lead to severe complications like toxic, septic, or allergic disorders.
  • Toxin-mediated complications (TMC) can affect multiple organs during the acute phase of illness.

Observation:

  • A young woman presented with fever, sore throat, and exudative tonsillitis, initially testing negative for Streptococcus pyogenes.
  • The patient exhibited leukopenia, severe neutropenia, elevated inflammatory markers, and significant electrocardiographic (ECG) changes.
  • Cardiac symptoms were absent despite notable ECG abnormalities.

Findings:

  • Treatment with Penicillin G and dexamethasone led to rapid clinical improvement and normalization of leukocyte count and ECG.
  • High antistreptolysin O titre at discharge confirmed a recent streptococcal infection.

Implications:

  • This case underscores the importance of considering TMC in streptococcal infections, even with atypical presentations or initial negative tests.
  • Early recognition and appropriate management of TMC are crucial for preventing severe outcomes and ensuring rapid recovery.
Keywords:
leukopeniastreptococcal infectiontonsillitistoxic myocarditis

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