Related Experiment Videos
Necrotizing group A streptococcal infections associated with streptococcal toxic shock syndrome
B J Sellers1, M L Woods, S E Morris
1Department of Surgery, University of Utah School of Medicine, Salt Lake City 84132, USA.
Background:
Group A streptococci (GAS) cause a variety of life-threatening infectious complications, including necrotizing fasciitis (NF), purpura fulminans (PF), and streptococcal toxic shock syndrome (strepTSS), in which bacteremia is associated with shock and organ failure.
Methods:
We reviewed our experience in the management of patients with necrotizing GAS infections from 1991 to 1995.
Results:
Eight adult patients (6 NF, 2 PF) were identified. Patients presented with fever, leukocytosis, and severe pain, and rapidly developed shock and organ dysfunction. The diagnosis of strepTSS was confirmed in 6 cases. A total of 54 surgical procedures were required, including widespread debridements and amputations. Two patients died (25%).
Conclusions:
Recognition of the need for aggressive diagnosis and surgical treatment of this most rapidly progressive surgical infection is necessary for successful management.
Insights
Group A Streptococcus (GAS) can cause severe infections like necrotizing fasciitis and streptococcal toxic shock syndrome. Aggressive surgical intervention is crucial for managing these life-threatening conditions.
Area of Science:
- Infectious Diseases
- Surgical Infections
- Microbiology
Background:
- Group A Streptococcus (GAS) is a pathogen responsible for severe, life-threatening infections.
- Complications include necrotizing fasciitis (NF), purpura fulminans (PF), and streptococcal toxic shock syndrome (strepTSS).
- GAS bacteremia can lead to shock and organ failure.
Purpose of the Study:
- To review the management of patients with necrotizing GAS infections.
- To analyze clinical presentation, treatment, and outcomes.
Main Methods:
- Retrospective review of patient cases from 1991 to 1995.
- Inclusion criteria: adult patients with necrotizing GAS infections.
Main Results:
- Eight adult patients were identified (6 NF, 2 PF).
- Patients presented with fever, leukocytosis, severe pain, shock, and organ dysfunction.
- Six cases confirmed strepTSS; 54 surgical procedures were performed; mortality rate was 25%.
Conclusions:
- Necrotizing GAS infections are rapidly progressive surgical emergencies.
- Prompt diagnosis and aggressive surgical treatment are essential for successful patient outcomes.
- Early recognition and intervention can improve survival rates.