Toxic shock syndrome due to group a streptococcal pharyngitis and bacteremia in adults
Vucicevic, Z.; Jajic-Bencic, I.; Kruslin, B.; Degoricija, V.
Journal of Microbiology Immunology and Infection 42(3): 276-279
2009
ISSN/ISBN: 1995-9133 PMID: 19812863 Document Number: 630311
Bacteremia and/or toxic shock syndrome are rare complications of streptococcal pharyngitis in adults. This report describes a previously healthy young man with streptococcal toxic shock syndrome who presented with fatigue, high fever, and suspected extensive streptococcal tonsillopharyngitis. Treatment consisted of high-dose antibiotics followed by therapy for consumptive coagulopathy, acute renal failure, and toxic shock syndrome. An attempt at hemodialysis and hemodiafiltration was ineffective, and the patient died within 24 h of admission. The autopsy findings were compatible with the clinical diagnosis. The invasive group A streptococci isolated from the pharyngeal swab and blood cultures were identified as M1 and T1 types with pyrogenic exotoxin genes A and B. This was a definitive case of streptococcal toxic shock syndrome complicated with multiorgan failure and fatal outcome. The benefits of intravenous immunoglobulins, surgical intervention, or clindamycin for improving survival remain to be evaluated.