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[Toxic shock syndrome caused by Streptococcus pyogenes]

H Hohn1, A Kaufhold, J Schoenemann

  • 1Medizinische Abteilung, St.-Elisabeth-Krankenhauses Köln-Hohenlind.

Deutsche Medizinische Wochenschrift (1946)
|October 1, 1993
PubMed
Summary

A severe Streptococcus pyogenes infection mimicked toxic shock syndrome after an insect bite. Prompt intensive care and antibiotics led to the patient's complete recovery, though plastic surgery was needed for tissue damage.

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Area of Science:

  • Infectious Diseases
  • Toxicology
  • Dermatology

Background:

  • Streptococcus pyogenes (S. pyogenes) can cause severe invasive infections.
  • Toxic Shock Syndrome (TSS) is a life-threatening condition characterized by multi-organ failure.

Observation:

  • A 35-year-old woman developed extensive facial phlegmonous inflammation post-insect bite.
  • S. pyogenes serotype M1 was isolated from blood cultures.
  • The patient presented with symptoms consistent with S. pyogenes-induced toxic shock syndrome.

Findings:

  • The patient experienced high fever, diarrhea, vomiting, circulatory failure, consumption coagulopathy, renal dysfunction, and a generalized exanthem with desquamation.
  • Successful treatment involved intensive care, catecholamines, plasma, antithrombin III, and a multi-antibiotic regimen including clindamycin, ampicillin/sulbactam, imipenem, and gentamicin.

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  • Extensive necroses necessitated reconstructive plastic surgery.

    • Implications:

    • This case highlights the potential for S. pyogenes to cause severe TSS mimicking other conditions.
    • Early recognition and aggressive multi-modal treatment are crucial for patient survival.
    • Understanding the pathogenesis of S. pyogenes toxins is vital for developing targeted therapies.