2013
DOI: 10.1016/j.jpedsurg.2012.09.057
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Toxic shock syndrome due to group A beta-hemolytic streptococcus presenting with purpura fulminans and limb ischemia in a pediatric patient treated with early microsurgical arteriolysis

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Cited by 11 publications
(7 citation statements)
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“…In children, PF is usually caused by a hereditary deficiency of protein C, protein S, and antithrombin III involved in the coagulopathy pathogenesis. In adults, this syndrome is uncommon [ 3 , 4 ] and is often associated with a severe acute infection, especially meningococcus, staphylococcus aureus, and streptococcus infections [ 5 7 ]. However, the infection alone does not completely explain PF development or the rapidly progressive thrombotic disorder.…”
Section: Introductionmentioning
confidence: 99%
“…In children, PF is usually caused by a hereditary deficiency of protein C, protein S, and antithrombin III involved in the coagulopathy pathogenesis. In adults, this syndrome is uncommon [ 3 , 4 ] and is often associated with a severe acute infection, especially meningococcus, staphylococcus aureus, and streptococcus infections [ 5 7 ]. However, the infection alone does not completely explain PF development or the rapidly progressive thrombotic disorder.…”
Section: Introductionmentioning
confidence: 99%
“…Dhodapkar et al 3 described a case of a 5-year-old child with invasive S. pyogenes infection and purpura fulminans requiring vasopressor support who had good recovery without need for amputation. Daskalaki et al 4 also described a case of toxic shock due to S. pyogenes with purpura fulminans in a 2.5-year-old child who underwent arteriolysis to reestablish distal perfusion, but died 5 days into her hospital course. There is only one reported case of purpura fulminans (secondary to Hemophilus influenzae ) and septic shock requiring extracorporeal membrane oxygenation (ECMO) cannulation in the literature which resulted in multiple amputations and death despite successful disengagement from the ECMO circuit.…”
Section: Introductionmentioning
confidence: 99%
“…This case is unusual in that GABHS is rarely implicated as a cause of AIPF, and to our knowledge, there are only three previous reports of the same in English literature, all in the pediatric age group. [ 3 4 5 ] Acute infectious or postinfectious PF is more common in children and is reported in adults only in the setting of asplenia/other inherited or acquired immunodeficiencies where capsulated organisms such as Pneumococcus are usually responsible. Our patient was a healthy adult male without any underlying comorbidities.…”
mentioning
confidence: 99%