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Septic scarlet fever due to Streptococcus pyogenes cellulitis
The Quarterly Journal of Medicine
|November 1, 1988
Abstract:
We report three cases of septic scarlet fever due to Streptococcus pyogenes Group A (serotype M1/T1/OF-) cellulitis in healthy young adults. Despite prompt treatment two of the patients died. Such cases of cellulitis associated with scarlet fever, severe toxaemia and septicaemia have not been reported in the post-antibiotic era.
Insights
Severe Streptococcus pyogenes Group A infections caused septic scarlet fever and cellulitis in three healthy adults. Despite prompt antibiotic treatment, two patients died, highlighting a rare and aggressive post-antibiotic era presentation.
Area of Science:
- Infectious Diseases
- Bacteriology
- Clinical Medicine
Background:
- Streptococcus pyogenes (Group A Streptococcus) is a significant human pathogen.
- Scarlet fever and cellulitis are common Streptococcus pyogenes infections.
- Septic presentations are typically associated with specific risk factors.
Observation:
- Three healthy young adults presented with severe cellulitis.
- The cellulitis was associated with scarlet fever and signs of severe toxaemia.
- Blood cultures were positive for Streptococcus pyogenes Group A (serotype M1/T1/OF-).
Findings:
- Two of the three patients experienced fatal outcomes despite prompt antibiotic therapy.
- This represents a rare and aggressive clinical presentation of Streptococcus pyogenes infection.
- Such severe cases of cellulitis with scarlet fever, toxaemia, and septicaemia are unreported in the post-antibiotic era.
Implications:
- This case series underscores the potential for severe, life-threatening Streptococcus pyogenes infections even in healthy individuals.
- It highlights the need for heightened clinical suspicion for aggressive disease in patients presenting with cellulitis and scarlet fever.
- Further research into the virulence factors of specific Streptococcus pyogenes strains (e.g., M1/T1/OF-) may be warranted.