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toxic shock streptococcal syndrome

Shaolong Chen, Wenlong Xie, Kai Wu, Ping Li, Zhiqiang Ren, Lin Li, Yuan Yuan, Chunmao Zhang, Yuling Zheng, Qingyu Lv, Hua Jiang, Yongqiang Jiang
Most of the deaths that occurred during two large outbreaks of Streptococcus suis infections in 1998 and 2005 in China were caused by streptococcal toxic shock syndrome (STSS), which is characterized by increased vascular permeability. Heparin-binding protein (HBP) is thought to mediate the vascular leakage. The purpose of this study was to investigate the detailed mechanism underlying the release of HBP and the vascular leakage induced by S. suis. Significantly higher serum levels of HBP were detected in Chinese patients with STSS than in patients with meningitis or healthy controls...
2016: Frontiers in Microbiology
Marjan Islam, Dennis Karter, Jerry Altshuler, Diana Altshuler, David Schwartz, Gianluca Torregrossa
Infections from Streptococcus dysgalactiae ssp. equisimilis (SDSE) can cause a wide variety of infections, ranging from mild cellulitis to invasive disease, such as endocarditis and streptococcal toxic shock-like syndrome (TSLS). Despite prompt and appropriate antibiotics, mortality rates associated with shock have remained exceedingly high, prompting the need for adjunctive therapy. IVIG has been proposed as a possible adjunct, given its ability to neutralize a wide variety of superantigens and modulate a dysregulated inflammatory response...
2016: Case Reports in Infectious Diseases
Minako Yokoyama, Fumie Oyama, Asami Ito, Megumi Yokota, Daisuke Matsukura, Shinji Tsutsumi, Tomonori Kasai, Yohshiro Nitobe, Akiko Morikawa, Takashi Ozaki, Yoshihito Yokoyama
PURPOSE: We encountered a case where an infection with group A streptococcus (GAS; ie, Streptococcus pyogenes) initially caused primary peritonitis and then subsequently caused streptococcal toxic shock syndrome. The patient's life was likely saved by an emergency laparotomy followed by extensive peritoneal lavage and drainage. CASE PRESENTATION: A 40-year-old woman was admitted to the Emergency Department for lower abdominal pain and numbness in the extremities...
2016: Clinical Medicine Insights. Case Reports
Fabiola Mancini, Francesco Adamo, Roberta Creti, Monica Monaco, Giovanna Alfarone, Annalisa Pantosti, Alessandra Ciervo
We report the first human fatal case of streptococcal toxic shock syndrome (STSS) caused by Streptococcus suis serotype 2 carrying the tetracycline efflux tet (40) gene and the tetracycline ribosomal protection tet (O/W/32/O) gene. The patient was splenectomized. The case was characterized by multi-organ dysfunction and disseminated intravascular coagulopathy, in accordance with the clinical parameters of STSS. More investigations are needed to improve the epidemiology and the pathogenesis of S. suis in human infection...
August 20, 2016: Journal of Infection and Chemotherapy: Official Journal of the Japan Society of Chemotherapy
Stephen H Gregory, Madhav Swaminathan, Yasmin Maisonave, Kelly A Machovec
The number of patients reaching adulthood after undergoing Fontan palliation for the repair of a congenital heart defect continues to increase. In this case report, we present the anesthetic management of a patient with a history of tricuspid atresia treated with palliative Fontan repair who had developed clinical evidence of Fontan failure. He presented with septic shock secondary to streptococcal toxic shock syndrome complicated by a loculated pleural effusion. He underwent open thoracic decortication under 1-lung ventilation...
October 15, 2016: A & A Case Reports
Sunil D Saroj, Lisa Maudsdotter, Raquel Tavares, Ann-Beth Jonsson
Streptococcus pyogenes [Group A streptococcus (GAS)], a frequent colonizer of the respiratory tract mucosal surface, causes a variety of human diseases, ranging from pharyngitis to the life-threatening streptococcal toxic shock-like syndrome. Lactobacilli have been demonstrated to colonize the respiratory tract. In this study, we investigated the interference of lactobacilli with the virulence phenotypes of GAS. The Lactobacillus strains L. rhamnosus Kx151A1 and L. reuteri PTA-5289, but not L. salivarius LMG9477, inhibited the hemolytic activity of S...
2016: Frontiers in Microbiology
Kei Suzuki, Akiko Nakamura, Ken Ishikura, Hiroshi Imai
A 19-year-old man with chronic lymphoedema due to Noonan syndrome presented at our hospital with septic shock and pain in his lower leg. Blood cultures were positive for Streptococcus dysgalactiae subsp equisimilis (SDSE), resulting in a diagnosis of cellulitis with toxic involvement. He was treated with ampicillin for 3 weeks. Although he did well for 6 weeks, septic shock recurred. Blood culture again revealed SDSE, with the strain being identical to the first episode, suggesting that this infection had relapsed...
2016: BMJ Case Reports
Katie Young, Faraz Khan Luni, Youngsook Yoon
Streptococcal toxic shock syndrome is a rapidly fatal disease causing hypotension with multi organ dysfunction (MODS) early in the course of infection, which by definition is caused by Group A streptococcus (GAS). We describe a case of Toxic Shock like Syndrome (TSLS) in which the causative organism was not a GAS. A 71-year-old woman with hepatitis C and primary biliary cirrhosis had sudden onset of slurred speech and left arm and facial numbness. She had bilateral erythematous macular rash present on the flanks and legs...
July 2016: American Journal of the Medical Sciences
Qiwei Paulson, Elizabeth Douglass, Alejandro Moreno, Jayson Aydelotte
Group A β-hemolytic streptococcus (GAS) is well known to cause upper respiratory tract or cutaneous infections, but some more virulent species of GAS can lead to a rapidly progressive life threatening soft tissue necrotizing infection and streptococcal toxic shock syndrome (STSS). In the modern era, GAS infections within the female reproductive tract leading to STSS are unusual and are often the result of retained products of conception or intrauterine devices. This report describes a case of GAS necrotizing pelvic infection in a previously healthy menopausal woman with no obvious portal of entry...
2016: IDCases
Laurent Zieleskiewicz, Anne Chantry, Gary Duclos, Aurelie Bourgoin, Alexandre Mignon, Catherine Deneux-Tharaux, Marc Leone
In developed countries, the rate of obstetric ICU admissions (admission during pregnancy or the postpartum period) is between 0.5 and 4 per 1000 deliveries and the overall case-fatality rate is about 2%. The most two common causes of obstetric ICU admissions concerned direct obstetric pathologies: obstetric hemorrhage and hypertensive disorders of pregnancy. This review summarized the principles of management of critically ill pregnant patient. Its imply taking care of two patients in the same time. A coordinated multidisciplinary team including intensivists, anesthesiologists, obstetricians, pediatricians and pharmacists is therefore necessary...
October 2016: Anaesthesia, Critical Care & Pain Medicine
Chen-Yi Liao, Kuan-Jen Su, Cheng-Hui Lin, Shu-Fang Huang, Hsien-Kuo Chin, Chin-Wen Chang, Wu-Hsien Kuo, Ren-Jy Ben, Yen-Cheng Yeh
Viridians streptococcal shock syndrome is a subtype of toxic shock syndrome. Frequently, the diagnosis is missed initially because the clinical features are nonspecific. However, it is a rapidly progressive disease, manifested by hypotension, rash, palmar desquamation, and acute respiratory distress syndrome within a short period. The disease course is generally fulminant and rarely presents initially as a purpura over the plantar region. We present a case of a 54-year-old female hospital worker diagnosed with viridians streptococcal shock syndrome caused by Streptococcus gordonii...
2016: Canadian Journal of Infectious Diseases & Medical Microbiology
Tadayoshi Ikebe, Takayuki Matsumura, Hisako Nihonmatsu, Hitomi Ohya, Rumi Okuno, Chieko Mitsui, Ryuji Kawahara, Mitsuhiro Kameyama, Mari Sasaki, Naomi Shimada, Manabu Ato, Makoto Ohnishi
Streptococcus pyogenes (group A Streptococcus; GAS) is a widespread human pathogen and causes streptococcal toxic shock syndrome (STSS). STSS isolates have been previously shown to have high frequency mutations in the csrS/csrR (covS/covR) and/or rgg (ropB) genes, which are negative regulators of virulence. However, these mutations were found at somewhat low frequencies in emm1-genotyped isolates, the most prevalent STSS genotype. In this study, we sought to detect causal mutations of enhanced virulence in emm1 isolates lacking mutation(s) in the csrS/csrR and rgg genes...
2016: Scientific Reports
Stephan Brouwer, Timothy C Barnett, Tania Rivera Hernandez, Manfred Rohde, Mark J Walker
Streptococcus pyogenes (group A Streptococcus, GAS) is a human-adapted pathogen responsible for a wide spectrum of disease. GAS can cause relatively mild illnesses such as strep throat or impetigo, and less frequent but severe life-threatening diseases such as necrotizing fasciitis and streptococcal toxic shock syndrome. GAS is an important public health problem causing significant morbidity and mortality worldwide. The main route of GAS transmission between humans is through close or direct physical contact, and particularly via respiratory droplets...
June 17, 2016: FEBS Letters
José Paulo de Souza, Amanda Ribeiro Santos, Geraldo Renato de Paula, Rosana Rocha Barros
BACKGROUND: Streptococcus dysgalactiae subsp. equisimilis (SDSE) has been increasingly associated with several infectious diseases, ranging from pharyngitis to life-threatening conditions, such as necrotizing fasciitis and streptococcal toxic shock syndrome. However, its molecular epidemiology in some geographical areas remains unclear. METHODS: In this study, 44 isolates of SDSE, recovered from noninvasive infections (37) and from carriage (7), during 2008-2013, were submitted to antimicrobial susceptibility testing, emm typing and pulsed-field gel electrophoresis (PFGE) analysis...
September 2016: Infectious Diseases
Supeng Yin, Ming Li, Xiancai Rao, Xinyue Yao, Qiu Zhong, Min Wang, Jing Wang, Yizhi Peng, Jiaqi Tang, Fuquan Hu, Yan Zhao
Streptococcus suis serotype 2 is an emerging zoonotic pathogen that triggered two outbreaks of streptococcal toxic shock syndrome (STSS) in China. Our previous research demonstrated that a type IV secretion system (T4SS) harbored in the 89K pathogenicity island contributes to the pathogenicity of S. suis 2. In the present study, a shotgun proteomics approach was employed to identify the effectors secreted by T4SS in S. suis 2, and surface-associated subtilisin-like protease-1 (SspA-1) was identified as a potential virulence effector...
2016: Scientific Reports
Aldo D Cancellara, Pablo Melonari, María V Firpo, Andrea Mónaco, Gustavo C Ezcurra, Lía Ruizf, Alicia M Aletti, Gabriela Gregorio, Alejandra Gaiano, Alberto Aird, Luciana Bellone, Miriam Calvari, Carolina Torregrosa, Sandra Morinigo, María L Vozzan, Ivana Tonetto, Luis P Flynn, Nancy M Bidone, Carlota Russ, Alejandro Ellis
INTRODUCTION: Invasive Streptococcus pyogenes infections (ISpIs) cause a high morbidity and mortality, even at present; however, at a regional level there are few publications on this subject in the field of pediatrics. OBJECTIVE: To describe the prevalence, predisposing factors and clinical characteristics of children hospitalized for ISpI, and analyze risk factors associated with bacteremia and lethality. Material and methods. Retrospective, descriptive study on ISpIs in children <18 years old hospitalized in the Pediatric Ward of 20 healthcare facilities across Argentina between 2010 and 2012...
June 1, 2016: Archivos Argentinos de Pediatría
Stephanie Lee, Julian Kelly, Pierre R Smeesters, Andrew C Steer
No abstract text is available yet for this article.
March 2016: Journal of Paediatrics and Child Health
Katherine Y H Chen, Michael Cheung, David P Burgner, Nigel Curtis
BACKGROUND: There are limited data describing the epidemiology, management and outcomes of children with toxic shock syndrome (TSS), a potentially life-threatening illness. Here, we describe the incidence, clinical features, treatment and outcome of children with staphylococcal and streptococcal TSS in Victoria, Australia. METHODS: Retrospective chart review of children admitted between 2003 and 2014 to two tertiary paediatric referral centres who fulfilled the Centers for Disease Control and Prevention case definition of TSS...
August 2016: Archives of Disease in Childhood
George E Nelson, Tracy Pondo, Karrie-Ann Toews, Monica M Farley, Mary Lou Lindegren, Ruth Lynfield, Deborah Aragon, Shelley M Zansky, James P Watt, Paul R Cieslak, Kathy Angeles, Lee H Harrison, Susan Petit, Bernard Beall, Chris A Van Beneden
BACKGROUND: Invasive group A Streptococcus (GAS) infections are associated with significant morbidity and mortality rates. We report the epidemiology and trends of invasive GAS over 8 years of surveillance. METHODS: From January 2005 through December 2012, we collected data from the Centers for Disease Control and Prevention's Active Bacterial Core surveillance, a population-based network of 10 geographically diverse US sites (2012 population, 32.8 million). We defined invasive GAS as isolation of GAS from a normally sterile site or from a wound in a patient with necrotizing fasciitis (NF) or streptococcal toxic shock syndrome (STSS)...
August 15, 2016: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
Andrea L Herrera, Victor C Huber, Michael S Chaussee
Viral infections of the upper respiratory tract are associated with a variety of invasive diseases caused by Streptococcus pyogenes, the group A streptococcus, including pneumonia, necrotizing fasciitis, toxic shock syndrome, and bacteremia. While these polymicrobial infections, or superinfections, are complex, progress has been made in understanding the molecular basis of disease. Areas of investigation have included the characterization of virus-induced changes in innate immunity, differences in bacterial adherence and internalization following viral infection, and the efficacy of vaccines in mitigating the morbidity and mortality of superinfections...
2016: Frontiers in Microbiology
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