Streptokokken-Toxic-Shock-Syndrom bei einer Frau im Wochenbett: Kasuistik und Literaturübersicht

Abstract

A case of streptococcal toxic shock syndrome in a 29-year-old postpartum woman is described. The patient presented with hypotension, coagulation defects, adult respiratory distress syndrome and scarlet exanthema as a complication of hemolytic group A streptococcal endometritis. One hundred and twenty-two other cases of streptococcal toxic shock syndrome in the literature are reviewed and the criteria of the syndrome discussed. Streptococcal toxic shock syndrome seems to be increasing along with more frequent invasive streptococcal infections in several countries. It is therefore important to recognize and treat the infection as early as possible to minimize the risk of mortality.

How could we suspect life‐threatening perinatal group A streptococcal infection?

“…We included a total of 98 patients reported over a long time period (45 years) (Table 1 6–61 ). Patient characteristics were compared between antenatal and postnatal GAS infection groups (Table 2).…”

Thigh pyomyositis caused by group A streptococcus in an immunocompetent adult without any cause

“…Furthermore, GAS infection is a known complication of chicken pox in children [5], although only 1 of the 6 pediatric cases was GAS-positive. Although pyomyositis typically occurs in the lower extremities (9/24, 37.5%) [5, 9–27], other muscle groups can be involved, such as the iliac [10], psoas [11, 17], iliopsoas [11], trunk [5], neck [13, 18, 26, 27], and upper extremity muscles [14, 16, 19, 22, 25]. Involvement of multiple muscle groups is also common (9/24, 37.5%).…”

Puerperal fever caused by group A streptococci

“…Sie ist die schwerste Form einer A-Streptokokken-Infektion, die 1987 zum ersten Mal als solche von Cone et al [3] beschrieben wurde und die auch im Wochenbett vorkommen kann [6,9]. Neben den Symptomen einer invasi-ven A-Streptokokken-Infektion treten noch Zeichen eines septischen Schocks mit Multiorganversagen und sich fulminant entwickelnden Weichteilinfektionen (nekrotitisierende Fasziitis) auf [29].…”