Emerging infection: streptococcal toxic shock-like syndrome caused by group B Streptococcus (GBS), Streptococcus...

Area of Science:

• Infectious Diseases
• Bacteriology
• Critical Care Medicine

Background:

• Group B Streptococcus (GBS) infections are increasingly recognized in nonpregnant adults, posing risks to older individuals and those with comorbidities like diabetes mellitus and cancer.
• While typically associated with neonatal and maternal infections, GBS incidence is rising in the general adult population.
• Underlying conditions such as advanced age, diabetes, and cancer elevate the risk of severe GBS infections in adults.

Observation:

• A 77-year-old female with type-2 diabetes mellitus and hypertension presented with septic shock, bilateral necrotic foot ulcers, and necrotizing fasciitis.
• The patient underwent bilateral lower limb amputations due to the severity of the infection.
• Clinical presentation met the criteria for Streptococcal Toxic Shock Syndrome (STSS), typically defined for *Streptococcus pyogenes*.

Findings:

• Blood cultures confirmed Group B Streptococcus (*Streptococcus agalactiae*) as the causative agent.
• The patient fulfilled the STSS criteria, demonstrating the applicability of these criteria to GBS infections.
• This case underscores the potential for GBS to cause severe, invasive disease mimicking infections caused by Group A Streptococcus.

Implications:

• Early detection and prompt antibiotic therapy are crucial for managing GBS infections.
• Aggressive surgical management, including debridement and amputation, is vital for necrotizing soft tissue infections like necrotizing fasciitis.
• Recognizing GBS as a potential cause of STSS in nonpregnant adults is critical for timely and appropriate clinical intervention.