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Life-threatening complications of streptococcal sepsis: a PICU contemporary series

M Piastra1,2, V Ferrari3,4, E Picconi1

  • 1Pediatric Intensive Care Unit, Emergency Department, Fond.Policlinico Gemelli IRCCS, Roma, Italy.

Journal of Anesthesia, Analgesia and Critical Care
|June 29, 2023
PubMed

Insights

Severe streptococcal sepsis is rare in children but requires prompt intensive care. Different Streptococcus species cause distinct severe complications, including brain lesions, heart shock, or lung issues, necessitating aggressive treatment.

Area of Science:

  • Pediatrics
  • Infectious Diseases
  • Critical Care Medicine

Background:

  • Life-threatening streptococcal sepsis is an uncommon but severe condition in previously healthy children.
  • Critically ill patients may exhibit severe complications resembling pre-antibiotic era presentations.
  • Timely clinical intervention is essential for patient recovery.

Purpose of the Study:

  • To describe distinct clinical features and outcomes of severe streptococcal sepsis in different patient groups.
  • To emphasize the importance of early diagnosis and aggressive management in intensive care settings.

Main Methods:

  • Retrospective case series analysis of four patient groups with severe streptococcal sepsis.
  • Clinical data review focusing on presenting symptoms, causative Streptococcus species, and complications.

Main Results:

  • Streptococcus Agalactiae sepsis was linked to cerebral thrombotic/ischemic lesions.
  • Streptococcus Viridans sepsis presented with severe cardiogenic shock.
  • Streptococcus Faecalis and beta-hemolytic group A Streptococcus infections predominantly caused lung complications.

Conclusions:

  • Early diagnostic suspicion of severe streptococcal sepsis is critical.
  • Aggressive treatment in an intensive care setting is crucial for favorable clinical outcomes.
  • Prior antibiotic therapy should not impede the initiation of intensive care interventions.
Abstract

Keywords:
Intensive careMechanical ventilationSeptic shockStreptococcal sepsis complicationsTissue tropism phenotypes

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