title: [A case of toxic shock-like syndrome due to Streptococcus pyogenes].
abstract: A case of toxic-shock syndrome due to Streptococcus pyogenes is reported. A 76-year-old female was admitted with complaints of fevers and chills. She had been suffering from cellulitis on her right dorsum pedis for 7 months. Laboratory data on admission showed elevated values of WBC, CRP, and dysfunction of the liver and kidney. She was diagnosed as sepsis due to the cellulitis, and was treated with PIPC and FMOX. However, several hours after admission, her blood pressure decreased and oliguria appeared. Bacteriological examinations from the blood and the cellulitis revealed group A beta-hemolytic Streptococcus which gave streptococcal pyrogenic exotoxin (T-28, SPE.B + C). She died 23 hours after her admission in spite of changing antibiotics to a high-dose of PC-G therapy. This is one of the rare cases of toxic shock-like syndrome due to Streptococcus pyogenes from the cellulitis of the dorsum pedis.
authors.affiliation: Department of Internal Medicine, Kitasato Institute Hospital.
authors.forename: T
authors.initials: T
authors.lastname: Okabe
authors.forename: N
authors.initials: N
authors.lastname: Kumagai
authors.forename: H
authors.initials: H
authors.lastname: Serizawa
authors.forename: H
authors.initials: H
authors.lastname: Nishimura
authors.forename: Y
authors.initials: Y
authors.lastname: Suzuki
authors.forename: N
authors.initials: N
authors.lastname: Iwabuchi
authors.forename: N
authors.initials: N
authors.lastname: Watanabe
authors.forename: Y
authors.initials: Y
authors.lastname: Hamada
authors.forename: M
authors.initials: M
authors.lastname: Takahashi
authors.lastname: Tsuchimoto
mesh_terms: D000368:Aged; D002481:Cellulitis / Q000382:microbiology; D005260:Female; D006801:Humans; D012772:Shock, Septic / Q000382:microbiology* / Q000473:pathology; D013290:Streptococcal Infections; D013297:Streptococcus pyogenes