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Son and Shin: Group B Streptococcal Toxic Shock-like Syndrome: A Case Report and Review of the Literature
Original Article

Ann Clin Microbiol 2014;17(3):91-94.

Published online: 5 September 2014

DOI: https://doi.org/10.5145/ACM.2014.17.3.91

Group B Streptococcal Toxic Shock-like Syndrome: A Case Report and Review of the Literature

Bo Ra Son, Kyeong Seob Shin

Department of Laboratory Medicine, College of Medicine, Chungbuk National University, Cheongju, Korea

Correspondence: Kyeong Seob Shin, Department of Laboratory Medicine, College of Medicine, Chungbuk National University, 52 Naesudong-ro, Seowon-gu, Cheongju 362-763, Korea. (Tel) 82-43-269-6240, (Fax) 82-43-271-5243, (E-mail) ksshin@chungbuk.ac.kr

Received 25 February 20145 June 2014       Accepted 6 June 2014

Copyright © 2014 The Korean Society of Clinical Microbiology

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.

초록

Toxic shock syndrome is an acute and febrile illness that rapidly progress to shock and multi-organ failure, and it is caused by toxin-producing strains of Staphylococcus aureus or Streptococcus species. Streptococcal toxic shock syndrome (STSS) is usually caused by group A streptococci, but non-group A STSS is rare. In this study, we describe a case of STSS caused by Streptococcus agalactiae (group B streptococci) in a patient with alcoholic liver cirrhosis. At arrival in our hospital, the patient had a decreased mental status with hemorrhagic bullae on four extremities, and he progressed to a fatal outcome with-in 4 days in spite of antibiotic treatment.

Keywords: Liver cirrhosis, Streptococcus agalactiae, Toxic shock syndrome

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Table 1.
Comparison of patient characteristics reported group B streptococcal toxic shock syndrome cases
Sex/ Age Underlying risk factors Clinical appearance Complications Bacteriologic findings Treatment Outcome Reference
M/47 Hypothalamic hypofunction Desquamation of right leg Hypotension, coagulopathy, renal failure Blood culture positive for GBS Penicillin G, clindamycin Full recovery at 2 wks 5
F/67 Chronic lympho-cytic leukemia Necrotizingfasciitis Hypotension, coagulopathy,hepatic and renal failure GBS isolated frommuscle biopsy specimen Penicillin G,ceftriaxone, clindamycin Died onhospital day 8 8
M/42 Splenectomy for ITP Desquamation of face, neck, and genitals Hypotension, hepatic, renal failure and respiratory failure; DIC Blood culture positive for GBS Cefazolin, clindamycin Full recovery at 2 m 13
F/51 Cirrhosis and sarcoidosis;receiving oral prednisone Cellulitis of thigh Hypotension, hepatic failure Blood culture positive for GBS Clindamycin at 4 days Full recovery 14
M/74 Alcoholic liver cirrhosis Generalized erythema with hemorrhagic bullae of four extremities Hypotension, coagulopathy, hepatic and renal failure, respiratory failure GBS isolated from urine and bullae sites Vancomycin, meropenem, ceftazidime, doxycycline Died on hospital day 4 Present case

Abbreviations: DIC, disseminated intravascular coagulopathy; GBS, group B streptococci; ITP, idiopathic thrombocytopenic purpura.

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