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Toxic shock syndrom

Kohei Ogura, Kayo Okumura, Yukiko Shimizu, Teruo Kirikae, Tohru Miyoshi-Akiyama
Streptococcus dysgalactiae subsp. equisimilis (SDSE) causes severe invasive diseases such as streptococcal toxic shock syndrome, similar to that caused by S. pyogenes (GAS). Invasive SDSE infections are increasing, particularly among patients with diabetes mellitus. Here we investigate the association between the pathogenicity of SDSE and diabetes mellitus in a mouse model, using GAS infection for comparison. Intraperitoneal injection of highly hemolytic SDSE-167 into C57BL6/J mice induced a rapid rise in blood glucose concentrations within 4 h, which was otherwise seen only in mice injected with high doses of hypervirulent GAS mutants...
2018: Frontiers in Microbiology
Yves Gillet, Thomas Henry, Francois Vandenesch
Fulminant staphylococcal infection indicates an explosive, intense, and severe infection occurring in a patient whose previous condition and antecedent would never have caused any anticipation of life-threatening development. This includes necrotizing pneumonia, necrotizing fasciitis, and to some extent toxic shock syndrome and infective endocarditis. In the three former diseases, toxin production plays a major role whereas in the latter (fulminant presentation of infective endocarditis), association with any particular toxinic profile has never been demonstrated...
October 2018: Microbiology Spectrum
Katelyn L Parrish, Kristine M Wylie, Patrick J Reich, Patrick G Hogan, Todd N Wylie, Colleen R Kennedy, William Lainhart, David A Hunstad, Carey-Ann D Burnham, Stephanie A Fritz
We report here the prevalence of the tst-1 gene among 252 methicillin-susceptible Staphylococcus aureus (MSSA) isolates and 458 methicillin-resistant S aureus (MRSA) isolates collected from 531 subjects between 2008 and 2017, one of which was recovered from a child with MRSA toxic shock syndrome. tst-1 was encoded by 43 (6%) S aureus isolates overall: 42 (16.7%) MSSA isolates and 1 (0.2%) MRSA isolate (P < .001).
October 4, 2018: Journal of the Pediatric Infectious Diseases Society
Heather Lusby, Aaron Brooks, Eden Hamayoun, Amanda Finley
A 44-year-old Caucasian female with a history of endometriosis is admitted to the intensive care unit due to severe left lower quadrant abdominal pain, nausea and vomiting. With patients' positive chandelier sign on pelvic examination, leucocytosis, elevated erythrocyte sedimentation rate and elevated C-reactive protein indicated that she had pelvic inflammatory disease (PID). PCR tests were negative for Neisseria gonorrhoeae and Chlamydia trachomatis ; however, her blood and urine cultures grew Group A streptococci (GAS) with a negative rapid Streptococcus throat swab and no known exposure to Streptococcus On further review, patient met criteria for GAS toxic shock syndrome based on diagnostic guidelines...
September 23, 2018: BMJ Case Reports
Richard H Kallet, Kelly Ho, Michael S Lipnick, Michael A Matthay
Background: Common causes of acute respiratory distress syndrome (ARDS) include pneumonia, aspiration, non-pulmonary sepsis and trauma. Little is known about pulmonary mechanics and gas exchange in less-common etiologies of ARDS, which comprises 12-23% of cases. Our hospital's ARDS quality assurance database contained a substantial number of these cases. This descriptive study examines the pulmonary mechanics, and gas exchange characteristics of this diverse cohort of ARDS subjects. Methods: Between March 2010 and April 2017 we identified 94 subjects with less common etiologies of ARDS who had dead space fraction (VD /VT ) and respiratory system compliance (CRS ) measured within 24 hours of ARDS onset; 86 of whom did not have sepsis as a co-diagnosis...
August 2018: Journal of Thoracic Disease
Marylin Schmitz, Xavier Roux, Benedikt Huttner, Jérôme Pugin
The streptococcal toxic shock syndrome is a severe complication associated with invasive infections by group A streptococci. In spite of medical progresses in the care of patients with septic shock during the last decades, this condition has remained associated with a high mortality. Early recognition and multidisciplinary management are key to the care of patients with streptococcal toxic shock syndrome, with intensive and appropriate intensive support of failing organs, rapid diagnosis of infectious source(s), and surgical management...
September 17, 2018: Annals of Intensive Care
Suba Nookala, Santhosh Mukundan, Alexander Fife, Jeyashree Alagarsamy, Malak Kotb
Invasive Group A Streptococcus (GAS) infections include necrotizing soft tissue infections (NSTI) and streptococcal toxic shock syndrome (STSS). We have previously shown that host HLA class-II allelic variations determine the risk for necrotizing fasciitis (NF), a dominant subgroup of NSTI, and STSS by modulating responses to GAS superantigens (SAgs). SAgs are pivotal mediators of uncontrolled T-cell activation, triggering a pro-inflammatory cytokine storm in the host. FoxP3-expressing CD4+ CD25+ T-regulatory cells (Tregs) comprise phenotypically and functionally heterogeneous subsets with a profound ability to suppress inflammatory responses...
September 17, 2018: Infection and Immunity
Mie Kurosawa, Masataka Oda, Hisanori Domon, Toshihito Isono, Yuki Nakamura, Issei Saitoh, Haruaki Hayasaki, Masaya Yamaguchi, Shigetada Kawabata, Yutaka Terao
Streptococcus pyogenes is a bacterium that causes systemic diseases such as pharyngitis and toxic shock syndrome. S. pyogenes produces molecules that inhibit the function of the human immune system, thus allowing to grow and spread of the pathogen in tissues. It is known that S. pyogenes Christie Atkins Munch-Petersen (CAMP) factor induces vacuolation in macrophages, but the mechanism remains unclear. In the current study, we investigated the mechanism of vacuolation induced by CAMP factor in macrophages. CAMP factor induced calcium ion uptake in murine macrophage RAW264...
September 13, 2018: Microbiology and Immunology
Naomi So, Erica Leavitt, Maria Aleshin, Scott Worswick
Toxic shock syndrome (TSS) can sometimes mimic Steven Johnsons syndrome/toxic epidermal necrolysis (SJS/TEN). Tumor necrosis factor (TNF) alpha is thought to play a role in the pathogenesis of both TSS and SJS/TEN. Etanercept, a TNF-alpha inhibitor has been recently shown to treat and decrease mortality of SJS/TEN. We report a 51-year-old female with history of SJS presenting with painful skin and bullae 2 days following cystoscopy with botulinum toxin injection into the bladder. Due to initial concern for SJS/TEN, the patient was treated with 50 mg of subcutaneous etanercept...
September 2, 2018: Dermatologic Therapy
Yukio Mizuguchi, Norimasa Taniguchi, Akihiko Takahashi
BACKGROUND: Streptococcal toxic shock syndrome caused by Streptococcus pyogenes, a group A streptococcus, infection is a rare condition that rapidly progresses to multiple organ failure, shock, and death. It is thus important to promptly establish a diagnosis, provide hemodynamic support, and initiate appropriate antibiotics therapy. CASE PRESENTATION: A 70-year-old Asian man presented with ventricular fibrillation. Extracorporeal membrane oxygenation was initiated 20 minutes after admission after unsuccessful conventional cardiopulmonary resuscitation including five attempts of electrical cardioversion...
September 1, 2018: Journal of Medical Case Reports
Shomron Ben-Horin, Gert Van Assche, Yehuda Chowers, Ella Fudim, Bella Ungar, Orit Picard, Miri Yavzori, Uri Kopylov, Mao Ren, Min-Hu Chen, Yael Peled-Potashnik, Itai Gueta, Rami Eliakim, Ronen Loebstein, Noa Markovits
Introduction: Thiopurine analogues discontinuation is common prior to live vaccines, during infection or when de-escalating therapy. Data regarding clearance of active metabolites and immune re-constitution is scant. Objectives: To determine drug elimination and immune re-constitution following thiopurine cessation. Methods: 6-thioguanine nucleotides (6-TGN) elimination kinetics were determined in 9 inflammatory bowel disease (IBD) patients discontinuing thiopurines...
August 27, 2018: Journal of Crohn's & Colitis
Zhiwei Li, Peixi Chang, Jiali Xu, Chen Tan, Xiaohong Wang, Weicheng Bei, Jinquan Li
Background: Streptococcus suis (S. suis) is an encapsulated zoonotic pathogen. Increasing antimicrobial resistance invokes the need for effective vaccines. Despite many attempts to develop an effective vaccine, none is currently available. Methods: A capsular polysaccharide (CPS)-expressing attenuated mutant 2015033 was constructed by deleting five virulence-associated factors (sly, scpA, ssnA, fhb, and ssads) in an outbreak S. suis strain SC19. The safety and the immune effect of 2015033 were determined both in vitro and in vivo...
August 27, 2018: Journal of Infectious Diseases
S A Mekonnen, T J G M Lam, J Hoekstra, V P M G Rutten, T S Tessema, E M Broens, A E Riesebos, M P Spaninks, G Koop
BACKGROUND: Staphylococcus aureus is a contagious, opportunistic pathogen that causes clinical or subclinical mastitis in dairy cattle. The genetic background and antimicrobial resistance of isolates from Ethiopian dairy farms has not been studied. Therefore, the aim of this study was to characterize S. aureus from Ethiopian hand milked dairy cows, by spa, MLST and virulence factor typing, and by assessment of antimicrobial susceptibility. A total of 79 S. aureus isolates from intramammary infections was studied...
August 23, 2018: BMC Veterinary Research
E C R Bonsaglia, N C C Silva, B F Rossi, C H Camargo, S T A Dantas, H Langoni, F F Guimarães, F S Lima, J R Fitzgerald, A Fernandes, V L M Rall
Bovine mastitis has been a concern for dairy herd for decades. The adaptation capacity of one of the main species responsible for this disease, Staphylococcus aureus (S. aureus), plays a pivotal role in this issue. The aim of this study was to establish a molecular and phenotypic profile of 285 S. aureus strains isolated from milk of subclinical mastitis cows from 18 different farms in São Paulo State using spa typing, multilocus sequence typing (MLST), pulsed field gel electrophoresis (PFGE), agr cluster (I, II, III and IV) typing, PCR for genes including enterotoxins (sea, seb, sec, sed, see, seg, seh, sei), toxic shock syndrome toxin (tsst-1), and Panton-Valentine leucocidin (pvl), as well as in vitro resistance assays for 12 antibiotics...
August 20, 2018: Microbial Pathogenesis
Bhavita Gaglani, Michelle Dahdouh, Kinchit Shah
Staphylococcus lugdunensis is a rare virulent coagulase-negative staphylococcus (CoNS) that behaves similarly to Staphylococcus aureus in causing deep abscesses, skin and soft tissue infections, and central nervous system infections. Additionally, there can be certain blood stream infections including sepsis, septic shock, toxic shock syndrome, and endocarditis complicated by embolic events. Reports of septic arthritis of a native joint associated with this organism have been infrequent, justifying the presentation and discussion of this case...
July 2018: Revista da Sociedade Brasileira de Medicina Tropical
H Bartoš, L Fabianová, P Dlouhý
Streptococcal toxic shock syndrome (STSS) is an acute, life-threatening condition which presents as a rapid onset shock and multiorgan failure (multiorgan dysfunction syndrome, MODS). This communication summarizes the existing body of evidence and presents three case reports. In two patients, STSS was caused by the bacterium Streptococcus pyogenes and in one patient, Streptococcus dysgalactiae was identified as the causative agent. STSS cases caused by other streptococcal species have been reported less often in the literature...
2018: Epidemiologie, Mikrobiologie, Imunologie
Zachary D Zuschlag, Matthew W Warren, Susan K Schultz
INTRODUCTION: Serotonin syndrome (SS) is a potentially serious side effect of serotonergic drugs. Cases of SS have been reported from the administration of methylene blue (MB), an agent with monoamine oxidase inhibiting properties. To date, the reported cases of MB-induced SS have all been with MB given parenterally. We report a case induced by the initiation of an MB-containing oral agent. METHODS: A case of SS felt to be induced by the initiation of an MB containing orally administered urinary analgesic, started in a patient concurrently treated with multiple serotonergic psychiatric drugs, is presented...
July 3, 2018: Psychosomatics
Roman Deniskin, Brittany Shah, Flor M Muñoz, Anthony R Flores
We report here 18 cases of pediatric group A streptococcal toxic shock syndrome, associated clinical findings, and bacterial molecular genetic characteristics discovered through whole-genome sequencing. This comparative whole-genome sequencing revealed unique gene content (speK) and polymorphisms (dpiB) in emm87 group A Streptococcus, the relative contributions of which, in combination with the host response, in the development of streptococcal toxic shock syndrome remain to be elucidated.
July 31, 2018: Journal of the Pediatric Infectious Diseases Society
Adel Elkbuli, Brandon Diaz, John D Ehrhardt, Shaikh Hai, Sean Kaufman, Mark McKenney, Dessy Boneva
INTRODUCTION: Clostridial toxic shock is a rare syndrome traditionally described in case studies and reviews as a uniformly fatal condition associated with post-partum and post-abortion. Clostridium sordellii was first mentioned in scientific literature as a human pathogen in 1922 when Argentinian microbiologist Alfredo Sordellii identified the organism in gangrenous wounds. Over the past century, there has been infrequent discussion and little awareness surrounding this serious condition...
2018: International Journal of Surgery Case Reports
C Z Hua, H Yu, L H Yang, H M Xu, Q Lyu, H P Lu, L Y Liu, X J Chen, C Q Wang
Objective: To improve the understanding of clinical characteristics of streptococcal toxic shock syndrome (STSS) caused by Streptococcus pyogenes ( S. pyogenes ) in children. Methods: A retrospective study was conducted to analyze the clinical data of STSS caused by S. pyogenes (culture-confirmed) in 7 tertiary hospitals during 2010-2017 in China. Clinical and laboratory data were collected by reviewing the medical records. Results: Fifteen cases of STSS, including 9 males, were confirmed and the ages of the patients ranged from 6 months to 15 years, with median age of 3 years...
August 2, 2018: Zhonghua Er Ke za Zhi. Chinese Journal of Pediatrics
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