Enfermedad invasiva por Streptococcus pyogenes : ingresos durante 6 años

Arias-Constantí, Vanessa; Maza, Victoria Trenchs Sainz de la; Sanz-Marcos, Nuria Elvira; Guitart, Carmina; Gené-Giralt, Amadeu; Luaces-Cubells, Carles

doi:10.1016/j.eimc.2017.06.005

Cited by 9 publications

(2 citation statements)

References 17 publications

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“…The rate of STSS in the patients treated in our ED was very low, with around two cases diagnosed per year, which suggests the importance of maintaining a high index of suspicion to detect it. 3,10 In this review, the majority of patients were younger than 5 years. This is in agreement with other published series 2,4 and suggests the role of the immaturity of the immune system and the higher prevalence of skin infections in younger children.…”

Section: Discussionmentioning

confidence: 89%

“…1 An incidence of 0.5 cases/100,000 inhabi-tants 2 is described in pediatrics, with an increase of invasive disease due to GAS in recent years. 3 The reason for this increase is not known, since no evidence is available to explain it. 4,5 Multiple risk factors have been described for the development of STSS, although none of them has become more frequent in recent years to account for the rise in cases.…”

Section: Introductionmentioning

confidence: 99%

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Streptococcal Toxic Shock Syndrome in the Emergency Department

Guitart

Constantí

Maza

et al. 2020

J Pediatr Infect Dis

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Objective Streptococcal toxic shock syndrome (STSS) is a very rare and severe entity from among the invasive diseases caused by Streptococcus pyogenes, whose characteristics, treatment, morbidity, and mortality are little known in pediatrics. The aim of this study was to determine its prevalence and the characteristics of its presentation in the emergency department (ED) in Spain. Methods This is a descriptive and observational study. Patients from 1 month to 18 years of age, admitted to the ED with a final diagnosis of STSS between 2009 and 2014, were included. Patients whose parents or guardians did not allow informed consent were excluded. Results Nine cases were diagnosed (1/100,000 consultations); the median average age was 2 years, and five were girls. No patient had a significant medical history. The most frequent reason for consultation was fever (9/9), followed by respiratory symptoms (6/9). Six presented in the ED with shock. Seven were diagnosed with pleuropneumonia, one with meningitis, and one with necrotizing fasciitis. All patients required admission at the pediatric intensive care unit, mechanical ventilation, and inotropic support. All had a complete recovery. Conclusion STSS is a rare entity in the ED affecting healthy patients who presented respiratory or otorhinolaryngology disease. In our patients, nonspecific clinical manifestations and its rapid progression to shock are shown, meaning the importance of bearing this entity in mind in the emergency room. Understanding the epidemiology and clinical manifestations of this syndrome in our work area helps pediatricians to recognize it and to initiate the appropriate treatment at an early stage, which helps engender a quick and effective approach, essential for a favorable prognosis.

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Section: Discussionmentioning

confidence: 89%

Section: Introductionmentioning

confidence: 99%