title: [Toxic shock-like syndrome in two adults caused by group A beta-hemolytic streptococci].
abstract: In two patients, a woman aged 34 and a man aged 38, toxic shock-like syndrome was diagnosed. This is a serious and potentially lethal disease characterized by multiorgan failure, fever, skin lesions and shock and caused by the exotoxin of Streptococcus pyogenes. Both patients had an invasive Lancefield group A beta haemolytic streptococcal infection. The first patient presented with a skin wound at the right knee and later developed shock and thrombosis, in the second a flu-like disease was complicated by respiratory insufficiency, rhabdomyolysis and acute renal insufficiency. Timely recognition of this infection may reduce the risk of complications such as adult respiratory distress syndrome, disseminated intravasal coagulation and necrotizing fasciitis. Both patients eventually recovered after antibiotic and intensive supporting therapy. This infection can be life-threatening and the fatality rate is 15-35% even if patients received appropriate antimicrobial therapy, supportive care, and, where necessary, surgical debridement.
authors.affiliation: Afd. Interne Geneeskunde, Reinier de Graaf Gasthuis, Delft.
authors.forename: W
authors.initials: W
authors.lastname: Yuen
authors.forename: E
authors.initials: E
authors.lastname: Maartense
authors.forename: R W
authors.initials: RW
authors.lastname: Vreede
mesh_terms: D058186:Acute Kidney Injury / Q000382:microbiology; D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D003422:Critical Care; D003937:Diagnosis, Differential; D005260:Female; D020022:Genetic Predisposition to Disease; D006801:Humans; D008297:Male; D012128:Respiratory Distress Syndrome / Q000382:microbiology; D012206:Rhabdomyolysis / Q000382:microbiology; D012772:Shock, Septic / Q000175:diagnosis / Q000382:microbiology* / Q000628:therapy; D013290:Streptococcal Infections / Q000175:diagnosis / Q000382:microbiology* / Q000628:therapy; D013297:Streptococcus pyogenes / Q000302:isolation & purification; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents
vernacular_title: Toxischeshock-achtig syndroom door beta-hemolytische streptokokken uit groep A bij twee volwassenen.