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Beta-Thalassemia Major Complicated by Streptococcal Toxic Shock Syndrome: A Rare Case of Survival and Successful
Fajr Saeedi1, Masaheer A Aljehani2
1Department of Pediatrics, Faculty of Medicine, King Abdulaziz University, Rabigh, Saudi Arabia, kau.edu.sa.
Abstract:
Beta-thalassemia is an inherited blood disorder associated with defective hemoglobin production and impaired immunity, increasing susceptibility to severe infections. Streptococcus pyogenes poses a significant risk due to its potential to cause streptococcal toxic shock syndrome (STSS), a life-threatening condition characterized by fever, shock, and multiorgan failure. We report a rare survival case of a nine-year-old child with beta-thalassemia major who developed STSS secondary to Streptococcus pharyngitis. The patient presented with fever, neck swelling, hematemesis, and hypovolemic shock, requiring urgent resuscitation and intensive care unit admission. Laboratory tests revealed pancytopenia and renal dysfunction, and neck CT showed diffuse lymphadenopathy and fluid collection. A nasal discharge culture confirmed Streptococcus pyogene as the cause. The patient received empirical antibiotics, intravenous immunoglobulin (two doses), and supportive care, leading to clinical recovery. The neck swelling resolved, and ultrasound confirmed no residual fluid collection. This case highlights the critical need for early recognition and aggressive management in beta-thalassemia patients with severe infections.
Insights
Beta-thalassemia patients are susceptible to severe infections. This case shows a child with beta-thalassemia major survived streptococcal toxic shock syndrome (STSS) with prompt treatment.
Area of Science:
- Pediatrics
- Infectious Diseases
- Hematology
Background:
- Beta-thalassemia impairs immunity, increasing infection risk.
- Streptococcus pyogenes can cause severe, life-threatening conditions like streptococcal toxic shock syndrome (STSS).
Purpose of the Study:
- To report a rare case of STSS survival in a pediatric beta-thalassemia major patient.
- To emphasize the importance of early recognition and management of severe infections in this population.
Main Methods:
- Case report of a nine-year-old child with beta-thalassemia major.
- Clinical presentation, laboratory findings, imaging (CT, ultrasound), and microbiological culture (Streptococcus pyogenes).
- Treatment included empirical antibiotics, intravenous immunoglobulin, and supportive care.
Main Results:
- The patient presented with fever, shock, pancytopenia, and renal dysfunction.
- STSS secondary to Streptococcus pharyngitis was diagnosed.
- Successful clinical recovery was achieved with prompt medical intervention.
Conclusions:
- Early recognition and aggressive management are crucial for beta-thalassemia patients with severe infections like STSS.
- This case demonstrates a favorable outcome is possible with timely and comprehensive care.
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