A Case of Group G Streptococcal Toxic Shock Syndrome

Shinwon Lee; Na Ra Yun; Kye-Hyung Kim; Jae Hyun Jeon; Yu Min Kang; Gayeon Kim; Sang Won Park; Hong Bin Kim; Nam Joong Kim; Myoung-don Oh

doi:10.3947/ic.2010.42.3.187

Journal List > Infect Chemother > v.42(3) > 1035007

Go to TopGo to Top Go to BottomGo to Bottom

TOOLS

Lee, Yun, Kim, Jeon, Kang, Kim, Park, Kim, Kim, and Oh: A Case of Group G Streptococcal Toxic Shock Syndrome

Case Report

Infection & Chemotherapy

Infection & Chemotherapy 2010; 42(3): 187-189.

Published online: 30 June 2010

DOI: https://doi.org/10.3947/ic.2010.42.3.187

A Case of Group G Streptococcal Toxic Shock Syndrome

Shinwon Lee, Na Ra Yun, Kye-Hyung Kim, Jae Hyun Jeon, Yu Min Kang, Gayeon Kim, Sang Won Park, Hong Bin Kim, Nam Joong Kim, Myoung-don Oh

Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.

Corresponding author: Nam Joong Kim, M.D. Department of Internal Medicine, Seoul National University College of Medicine, 28 Yeongun-dong, Chongro-gu, Seoul 110-744, Korea. Tel: +82-2-2072-0835, Fax: +82-2-762-9662, molder@unitel.co.kr

Revised 9 October 2009 Received 31 January 2010 Accepted 3 February 2010

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Toxic shock syndrome is an acute, multi-systemic, toxin-mediated illness caused by toxin-producing strains of Staphylococcus aureus and Streptococcus species. Streptococcal toxic shock syndrome is usually caused by Streptococcus pyogenes but Group G streptococcal toxic shock syndrome is rare. Herein, we report a case of group G streptococcal toxic shock syndrome that was successfully treated with toxin reducing antibiotics and intravenous immunoglobulin therapies.

Keywords: Streptococcus, Toxic shock syndrome

Figures and Tables

Figure 1

A CT scan of lower leg at initial presentation shows diffuse soft tissue infiltration or edema of the left leg.

References

1. Lappin E, Ferguson AJ. Gram-positive toxic shock syndromes. Lancet Infect Dis. 2009. 9:281–290.

2. Stevens DL. The toxic shock syndromes. Infect Dis Clin North Am. 1996. 10:727–746.

3. Cone LA, Woodard DR, Schlievert PM, Tomory GS. Clinical and bacteriologic observations of a toxic shock-like syndrome due to Streptococcus pyogenes. N Engl J Med. 1987. 317:146–149.

4. Bisno AL, Stevens DL. Mandell GL, Bennett JE, Dolin R, editors. Streptococcus pyogenes. Priniciples and practice of Infectious diseases. 2005. 6th ed. Philadelphia: Elsevier Inc.;2373.

5. Wagner JG, Schlievert PM, Assimacopoulos AP, Stoehr JA, Carson PJ, Komadina K. Acute group G streptococcal myositis associated with streptococcal toxic shock syndrome: case report and review. Clin Infect Dis. 1996. 23:1159–1161.

6. Kugi M, Tojo H, Haraga I, Takata T, Handa K, Tanaka K. Toxic shock-like syndrome caused by group G Streptococcus. J Infect. 1998. 37:308–309.

7. Horii T, Izumida S, Takeuchi K, Tada T, Ishikawa J, Tsuboi K. Acute peritonitis and salpingitis associated with streptococcal toxic shock syndrome caused by Lancefield group G alpha-haemolytic Streptococcus dysgalactiae subsp. equisimilis. J Med Microbiol. 2006. 55:953–956.

8. The Working Group on Severe Streptococcal Infections. Defining the group A streptococcal toxic shock syndrome: rationale and consensus definition. JAMA. 1993. 269:390–391.

9. Sendi P, Johansson L, Norrby-Teglund A. Invasive group B Streptococcal disease in non-pregnant adults: a review with emphasis on skin and soft-tissue infections. Infection. 2008. 36:100–111.

10. Hashikawa S, Iinuma Y, Furushita M, Ohkura T, Nada T, Torii K, Hasegawa T, Ohta M. Characterization of group C and G streptococcal strains that cause streptococcal toxic shock syndrome. J Clin Microbiol. 2004. 42:186–192.

11. Cunningham MW. Pathogenesis of group A streptococcal infections. Clin Microbiol Rev. 2000. 13:470–511.

12. Tan JS, File TM. Yu VL, Weber R, Raoult D, editors. Streptococcus species. Antimicrobial therapy and vaccines. 2002. 2nd ed. New York: Apple tree productions, LLC;736.

13. Zimbelman J, Palmer A, Todd J. Improved outcome of clindamycin compared with beta-lactam antibiotic treatment for invasive Streptococcus pyogenes infection. Pediatr Infect Dis J. 1999. 18:1096–1100.

14. Mascini EM, Jansze M, Schouls LM, Verhoef J, Van Dijk H. Penicillin and clindamycin differentially inhibit the production of pyrogenic exotoxins A and B by group A streptococci. Int J Antimicrob Agents. 2001. 18:395–398.

15. Norrby-Teglund A, Stevens DL. Novel therapies in streptococcal toxic shock syndrome: attenuation of virulence factor expression and modulation of the host response. Curr Opin Infect Dis. 1998. 11:285–291.

16. Darenberg J, Ihendyane N, Sjölin J, Aufwerber E, Haidl S, Follin P, Andersson J, Norrby-Teglund A. StreptIg Study Group. Intravenous immunoglobulin G therapy in streptococcal toxic shock syndrome: a European randomized, double-blind, placebo-controlled trial. Clin Infect Dis. 2003. 37:333–340.

TOOLS

Similar articles