Group B streptococcal toxic shock-like syndrome with fulminant cellulitis

Thomas, Sheeba K.; Cunha, Burke A.

doi:10.1016/s0147-9563(96)80053-7

Cited by 17 publications

(4 citation statements)

References 8 publications

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“…Both the frequency of GAS STSS and the 30‐day CFR were comparable with those in other studies [11,12]. The occurrence of STSS caused by GBS, GCS or GGS has been reported primarily in case series studies [36–42], but data from population‐based studies has not been presented previously in comparison with GAS STSS.…”

Section: Discussionsupporting

confidence: 81%

Invasive group A, B, C and G streptococcal infections in Denmark 1999–2002: epidemiological and clinical aspects

Ekelund

Skinhøj

Madsen

et al. 2005

Clinical Microbiology and Infection

131

117

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Group A streptococci (GAS) have been described frequently as an emerging cause of severe invasive infections in population-based surveillance studies, whereas the descriptions of group B, C and G streptococci (GBS, GCS and GGS) have been less frequent. Enhanced surveillance for invasive GAS, GBS, GCS and GGS was performed in Denmark in 1999-2002. A detailed questionnaire was completed for 1237 (98%) of 1260 invasive infections. GAS infections dominated (40%), followed by GGS (32%), GBS (23%) and GCS (6%). Most (74%) patients had predisposing factors, and there were no significant differences between the four serogroups when comparing the prevalence of cancer, diabetes mellitus, chronic heart or lung diseases, immunodeficiency or alcohol abuse. The overall case fatality rate at day 30 was 21%, increasing significantly to 59% for patients with streptococcal toxic shock syndrome (STSS). STSS was significantly more frequent in GAS patients (10%) than in GCS (4%), GBS (2%) and GGS (2%) patients. Regression analyses showed that, despite a younger median age among GAS patients, the probability of developing septic shock and mortality was significantly higher among GAS patients than among GBS and GGS patients. These analyses showed no significant differences between GAS and GCS infections. Invasive infections caused by GAS, GBS, GCS and GGS are still a major challenge for clinicians. Continued epidemiological and microbiological surveillance is important to assess the development of these infections and to improve preventative strategies.

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Section: Discussionsupporting

confidence: 81%

Invasive group A, B, C and G streptococcal infections in Denmark 1999–2002: epidemiological and clinical aspects

Ekelund

Skinhøj

Madsen

et al. 2005

Clinical Microbiology and Infection

131

117

View full text Add to dashboard Cite

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“…1,2,8,11,25,30,34,36,39,40 In the current study, we describe 2 new cases of GBS-induced TSLS. On reviewing the previously reported cases and our 2 new cases (Table 1), several comments can be made regarding clinical presentation and medical management.…”

Section: Resultsmentioning

confidence: 86%

Streptococcus agalactiae Toxic Shock-Like Syndrome

et al. 2013

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We present 2 patients with Streptococcus agalactiae toxic shock-like syndrome and review another 11 well-reported cases from the literature. Streptococcal toxic shock-like syndrome is a devastating illness with a high mortality rate, therefore we stress the importance of early supportive management, antimicrobial therapy, and surgical intervention. Toxic shock-like syndrome is likely to be underestimated in patients with invasive Streptococcus agalactiae infection who present with shock. Early diagnosis requires high suspicion of the illness, along with a thorough mucocutaneous examination. Streptococcus agalactiae produces uncharacterized pyrogenic toxins, which explains the ability of the organism to cause toxic shock-like syndrome.

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“…6 A novel toxin that was pyrogenic in rabbits and led to a fatal toxic shocklike syndrome was purified from this patient's GBS isolate. In 2 subsequent cases, each patient developed a soft tissue infection of the leg presenting as cellulitis 7 or necrotizing fasciitis, 8 but no desquamative cutaneous manifestations were reported.…”

Section: Commentmentioning

confidence: 99%