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Toxic shock syndrom

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...
July 29, 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
M Shahini Shams-Abadi, M Halaji, S M Hoseini-Alfatemi, A Gholipour, A Mojtahedi, H Sedigh Ebrahim-Saraie
BACKGROUND: S. aureus strains, with the capability of producing toxic shock syndrome toxin-1 (TSST-1), are more likely to cause complicated infections. However, due to lack of comprehensive local data on the prevalence of TSST-1, we aimed to determine the prevalence of TSST-1 harboring S. aureus isolates in Iran. METHODS: A systematic search was performed by using PubMed and Scopus databases from papers published by Iranian authors from January 2000 to the end of March 2017...
September 2018: Annali di Igiene: Medicina Preventiva e di Comunità
Andrea A Tarnutzer, Federica F Andreoni, Nadia N Keller, Claudia C Zürcher, Anna A Norrby-Teglund, Reto Ra Schuepbach, Annelies As Zinkernagel
OBJECTIVES: Streptococcus pyogenes causes life-threatening invasive infections including necrotizing fasciitis (NF). Current treatment guidelines recommend the use of a cell-wall active antibiotic combined with a protein synthesis inhibitor and surgical debridement in NF patients. Adjunctive therapy with intravenous immunoglobulin (IVIG) has been proposed for superantigen-associated streptococcal toxic shock syndrome. So far, benefits of IVIG treatment remain unclear and prospective clinical studies are scarce...
July 16, 2018: Clinical Microbiology and Infection
Rebecca A Flaherty, Deborah L Donahue, Katelyn E Carothers, Jessica N Ross, Victoria A Ploplis, Francis J Castellino, Shaun W Lee
The bacterial pathogen Group A Streptococcus (GAS) has been shown to induce a variety of human diseases ranging in severity from pharyngitis to toxic shock syndrome and necrotizing fasciitis. GAS produces a powerful peptide toxin known as Streptolysin S (SLS). Though long recognized as a potent cytolysin, recent evidence from our lab has shown that SLS-dependent cytotoxicity is mediated through activation of the pro-inflammatory mediators p38 MAPK and NFκB. These findings led us to hypothesize that activation of p38 MAPK and NFκB signaling drive the production of pro-inflammatory cytokines which, in turn, serve as positive feedback signals to initiate cytotoxicity in infected host cells...
2018: Frontiers in Cellular and Infection Microbiology
Krisana Asano, Kouji Narita, Shouhei Hirose, Akio Nakane
Toxic shock syndrome toxin-1 (TSST-1), a superantigen produced by Staphylococcus aureus is a causative agent of toxic shock syndrome (TSS) that is frequently associated with tampon use. It has long been suggested that TSS is induced when TSST-1 circulates through the body. However, the systemic distribution of TSST-1 from vagina or uterus has never been demonstrated. In this study, a mouse cervicovaginal infection model was established. Transcervical inoculation with a virulence strain of S. aureus and its derivative TSST-1-deficient mutant demonstrated that TSST-1 distributed to the bloodstream and spleen, and promoted systemic inflammation without bacteremia...
July 6, 2018: Medical Microbiology and Immunology
Zhongmin Xu, Bo Chen, Qiang Zhang, Liang Liu, Anding Zhang, Yujie Yang, Kaisong Huang, Shuxian Yan, Junping Yu, Xiaomei Sun, Meilin Jin
Two large-scale outbreaks of streptococcal toxic shock-like syndrome (STSLS) have revealed Streptococcus suis 2 to be a severe and evolving human pathogen. We investigated the mechanism by which S. suis 2 causes STSLS. The transcript abundance of the transcriptional regulator gene tstS was found to be upregulated during experimental infection. Compared with the wild-type 05ZY strain, a tstS deletion mutant (Δ tstS ) elicited reduced cytokine secretion in macrophages. In a murine infection model, tstS deletion resulted in decreased virulence and bacterial load, and affected cytokine production...
2018: Frontiers in Microbiology
Isaline Jacquemond, Anaëlle Muggeo, Gery Lamblin, Anne Tristan, Yves Gillet, Pierre Adrien Bolze, Michèle Bes, Claude Alexandre Gustave, Jean-Philippe Rasigade, François Golfier, Tristan Ferry, Audrey Dubost, Danis Abrouk, Samuel Barreto, Claire Prigent-Combaret, Jean Thioulouse, Gérard Lina, Daniel Muller
Menstrual toxic shock syndrome (mTSS) is a severe disease that occurs in healthy women vaginally colonized by Staphylococcus aureus producing toxic shock toxin 1 and who use tampons. The aim of the present study was to determine the impact of the composition of vaginal microbial communities on tampon colonisation by S. aureus during menses. We analysed the microbiota in menstrual fluids extracted from tampons from 108 healthy women and 7 mTSS cases. Using culture, S. aureus was detected in menstrual fluids of 40% of healthy volunteers and 100% of mTSS patients...
July 2, 2018: Scientific Reports
Kyra Gillard, Heather B Miller, Meghan S Blackledge
Methicillin-resistant Staphylococcus aureus (MRSA) is the leading cause of recurrent infections in humans including endocarditis, pneumonia, and toxic shock syndrome. Novel therapeutics to treat MRSA and other resistant bacteria are urgently needed. Adjuvant therapy, which uses a non-toxic compound to repotentiate the toxic effects of an existing antibiotic, is an attractive response to the growing resistance crisis. Herein, we describe the evaluation of structurally related, FDA-approved tricyclic amine antidepressants that selectively repotentiate MRSA to β-lactam antibiotics...
June 28, 2018: Chemical Biology & Drug Design
Shrein Saini, Robert A Duncan
A 32 year old female, an active intravenous drug user, was admitted for fever, myalgias and an erythematous macular rash on her distal extremities. She quickly decompensated and developed septic shock. Her examination was significant for a progressive rash which within two days developed bullae and necrosis with progression to a confluent rash involving her palms and soles (Figs. 1 and 2). Her rash involved nearly one third of her body with what was equivalent to a third degree burn. Her labs were significant for leukocytosis with bandemia, elevated liver function tests with worsening thrombocytopenia and fibrinogen levels consistent with disseminated intravascular coagulation (DIC) Her transthoracic echocardiogram (Fig...
2018: IDCases
Janet M Basinger, Steven E Fiester, James W Fulcher
A case of toxic shock syndrome associated with methicillin-resistant Staphylococcus aureus parotitis in a 13-year-old male is presented. He was initially diagnosed with left-sided parotitis by his primary care physician, was started on sulfamethoxazole/trimethoprim, and became severely ill the following day. He was transported to the hospital after a syncopal episode at home and was found to have altered mental status, hypotension, and hypoxia. He was transferred to a larger care facility and died en route despite aggressive resuscitation...
June 21, 2018: American Journal of Forensic Medicine and Pathology
Nadeem Ahmed Sheikh, Kanwal Nadeem
of the oral cavity. It may develop as a congenital defect e.g. cleft palate, or rarely, consequent to an operative procedure like a sub muco-perichondrial resection surgery of the nasal septum. After nasal septal corrective surgery, follow up of the patient with meticulous nasal toilet and detailed examination is mandatory. In operated patients who do not report to follow up, and later on present with persisting nasal discharge, pain, nasal blockage and exsanguination must alert a clinician for any evidence of a possibly retained foreign object...
April 2018: Journal of Ayub Medical College, Abbottabad: JAMC
Mary Meehan, Stephen Murchan, Patrick J Gavin, Richard J Drew, Robert Cunney
OBJECTIVES: Group A streptococcus (GAS) is responsible for mild to very severe disease. The epidemiology of an upsurge in invasive GAS (iGAS) infections in Ireland, 2012-2015 was investigated. METHODS: Epidemiological typing of iGAS (n = 473) isolates was performed and compared to non-invasive (n = 517) isolates. Clinical data of notified iGAS was obtained from the national infectious disease information system. RESULTS: Annual incidences of iGAS cases (n = 561) were 2...
June 20, 2018: Journal of Infection
Xiao-Ling Jia, Janak L Pathak, Jin-Fa Tong, Ji-Mei Su
BACKGROUND: Hemolytic streptococcus gangrene is a life threatening invasive bacterial infection. Hemolytic streptococcus gangrene in the danger triangle of the face is too lethal to operate. A case of the confirmed hemolytic streptococcus gangrene in the danger triangle of the face caused by Group A beta-hemolytic streptococcus (GAS) in 20-months old boy is presented to draw attention of clinicians to this uncommon but frequently fatal infection. CASE PRESENTATION: Previously healthy 20 months old boy suddenly developed paranasal gangrene on the left side of the danger triangle of the face, followed by rapidly progressive thrombocytopenia and hepatitis...
June 22, 2018: BMC Pediatrics
Tri Rejeki Herdiana, Yasuhiro Takahashi, Ma Regina Paula Valencia, Marian Grace Ana-Magadia, Hirohiko Kakizaki
Purpose: To report a case of periocular necrotizing fasciitis with toxic shock syndrome. Methods: This is a case report of a previously healthy 69-year-old woman with left preseptal eyelid infection that spread rapidly and deteriorated into necrosis of the eyelid with toxic shock syndrome. She was admitted to intensive care unit for hemodynamic stabilization. Results: Intravenous antibiotic and high-dose immunoglobulin were administered followed by surgical debridement...
May 2018: Case Reports in Ophthalmology
Sujay Kulkarni, Mithun Sharma, Padaki N Rao, Rajesh Gupta, Duvvuru N Reddy
Aims: We studied in-hospital predictors of mortality of acute on chronic liver failure (ACLF) in Indian patients. Methods: Patients admitted to the intensive care unit of our institute fulfilling the definition of ACLF based on the Asia-Pacific Association for Study of Liver Disease (APASL) consensus were included. Complete history and medical evaluation to assess the etiology of underlying liver cirrhosis and to identify the acute precipitating insult of worsening liver function was done...
June 2018: Journal of Clinical and Experimental Hepatology
Luisa Berenise Gamez-Gonzalez, Isabel Moribe-Quintero, Martin Cisneros-Castolo, Javier Varela-Ortiz, Mireya Muñoz-Ramírez, Martin Garrido-García, Marco Yamazaki-Nakashimada
BACKGROUND: Kawasaki disease shock syndrome (KDSS) is an uncommon presentation of Kawasaki disease (KD). KDSS has been associated with more severe markers of inflammation, coronary abnormalities and IVIG resistance. METHODS: A retrospective, descriptive study of children with KDSS in two hospitals was performed. Relevant articles about KD and shock were collected, demographic data, clinical presentation, laboratory variables, echocardiogram findings, treatment and special features were analyzed when available...
June 11, 2018: Pediatrics International: Official Journal of the Japan Pediatric Society
Simin Deng, Tong Xu, Qiong Fang, Lei Yu, Jiaqi Zhu, Long Chen, Jiahui Liu, Rui Zhou
Streptococcus suis is an emerging zoonotic pathogen causing streptococcal toxic shock like syndrome (STSLS), meningitis, septicemia, and even sudden death in human and pigs. Serious septicemia indicates this bacterium can evade the host complement surveillance. In our previous study, a functionally unknown protein SntA of S. suis has been identified as a heme-binding protein, and contributes to virulence in pigs. SntA can interact with the host antioxidant protein AOP2 and consequently inhibit its antioxidant activity...
2018: Frontiers in Immunology
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