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Experimental Human Pneumococcal Carriage
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Streptococcal Pharyngitis: Delving Deeper than the Throat.

Sadaf Sheikh1, Umair Javed2, Muhammad Akbar Baig2

  • 1Department of Emergency Medicine, Sultan Qaboos University Hospital, Muscat, Oman.

Journal of the College of Physicians and Surgeons--Pakistan : JCPSP
|June 9, 2021
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Summary
This summary is machine-generated.

A rare case of severe rhabdomyolysis and elevated liver function tests occurred in an 18-year-old with streptococcal pharyngitis. Prompt treatment included hydration, antibiotics, and hemodialysis.

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Area of Science:

  • Internal Medicine
  • Infectious Diseases
  • Toxicology

Background:

  • Streptococcal pharyngitis is common, but severe complications like rhabdomyolysis and liver dysfunction are rare.
  • Understanding the pathophysiology, including bacterial invasion and toxin effects, is crucial.

Observation:

  • An 18-year-old male presented with β-hemolytic streptococcal pharyngitis.
  • He developed acute rhabdomyolysis with extremely high creatine phosphokinase (111,856 IU/L).
  • Significant elevation in liver function tests, including AST (1862 U/L) and ALT (1003 U/L), was noted.

Findings:

  • This case highlights an exceptionally rare presentation of streptococcal pharyngitis.
  • The patient experienced severe muscle breakdown and liver injury, indicated by markedly elevated enzyme levels.
  • The combination of these severe complications in the context of streptococcal pharyngitis is infrequently reported.

Implications:

  • Physicians must consider rhabdomyolysis and elevated transaminases as potential complications of streptococcal pharyngitis.
  • Early recognition and appropriate management, including hydration, antibiotics, and supportive care like hemodialysis, are vital.
  • This case underscores the importance of recognizing and managing rare but serious infectious disease complications.