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Fatal group A streptococcal meningitis and toxic shock-like syndrome: case report

G P Jevon1, W M Dunne, H K Hawkins

  • 1Department of Pathology, Texas Children's Hospital, Houston.

Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America
|January 1, 1994
PubMed

Insights

A young girl rapidly died from toxic shock-like syndrome and meningitis caused by a specific group A Streptococcus strain. This strain produced a variant exotoxin linked to severe toxic shock-like syndrome cases.

Area of Science:

  • Infectious Diseases
  • Microbiology
  • Pathology

Background:

  • Group A Streptococcus (GAS) infections can lead to severe invasive diseases.
  • Toxic Shock Syndrome (TSS) is a severe, life-threatening condition.
  • Streptococcal Pyrogenic Exotoxins (SPEs) are key virulence factors in GAS.

Observation:

  • An 8-year-old previously healthy girl presented with flu-like symptoms.
  • She rapidly progressed to a toxic shock-like syndrome and died within 48 hours.
  • Autopsy revealed purulent meningitis.

Findings:

  • The etiological agent was identified as group A beta-hemolytic Streptococcus from cerebrospinal fluid (CSF).
  • The isolate belonged to clone ET 2, known for producing a variant streptococcal pyrogenic exotoxin A (SPEA 2).
  • This SPEA 2 variant has been recently associated with widespread toxic shock-like syndrome.

Implications:

  • This case highlights the potential for rapid, fatal progression of GAS infections, even in healthy individuals.
  • The role of the SPEA 2 variant in severe toxic shock-like syndrome warrants further investigation.
  • Understanding specific GAS clones and their toxins is crucial for diagnosing and managing severe streptococcal infections.

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