[A case report of toxic shock-like syndrome associated with prevalence of streptococcal pharingitis in the family].
A case of streptococcal toxic shock-like syndrome in a previously healthy, 57 year old Japanese female has been reported. Initially, she had a sore throat and low grade fever for 5 days. Because of sudden severe pain on the extremities and erythema on bilateral forearms, she was hospitalized. On admission, her conciousness was clear. Although profound hypotension, anuria and prolonged blood coagulation were observed. Antibiotics, fluid therapy and dopamine were given. Four hours after admission, she died in spite of resuscitation efforts, by sudden cardiac arrest. Streptococcus pyogenes was isolated in her blood. At the same time as when she died, three of the five people of the patient's family living with her, had pharingitis or pneumonia. From the pharynxs of the three people with pharingitis, Streptococcus pyogenes was also isolated. The serotype of all organisms was T11, and they produced exotoxintype B in vitro. This case suggests that infection of Streptococcus pyogenes is not essential for the development of toxic shock-like syndrome.
Department of Anaesth, Asahi General Hospital.
Y
Y
Shimizu
H
H
Sakashita
C
C
Takada
Y
Y
Otsuka
K
K
Ooe
R
R
Tsumita
D005192:Family Health; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D008875:Middle Aged; D010612:Pharyngitis / Q000209:etiology*; D012772:Shock, Septic / Q000150:complications*; D013290:Streptococcal Infections / Q000209:etiology*; D013297:Streptococcus pyogenes