title: Fatal group A Streptococcal toxic shock-like syndrome in a child with varicella: report of the first well documented case with detection of the genetic sequences that code for exotoxins spe A and B, in São Paulo, Brazil.
abstract: A previously healthy seven-year-old boy was admitted to the intensive care unit because of toxaemia associated with varicella. He rapidly developed shock and multisystem organ failure associated with the appearance of a deep-seated soft tissue infection and, despite aggressive treatment, died on hospital day 4. An M-non-typable, spe A and spe B positive Group A Streptococcus was cultured from a deep soft tissue aspirate. The criteria for defining Streptococcal toxic shock-like syndrome were fulfilled. The authors discuss the clinical and pathophysiological aspects of this disease as well as some unusual clinical findings related to this case.
authors.affiliation: Intensive Care Unit, Instituto de Infectologia Emílio Ribas, São Paulo, Brazil. jaquess@icr.hcnet.usp.br
authors.forename: J
authors.initials: J
authors.lastname: Sztajnbok
authors.forename: M
authors.initials: M
authors.lastname: Lovgren
authors.forename: M C
authors.initials: MC
authors.lastname: Brandileone
authors.forename: P C
authors.initials: PC
authors.lastname: Marotto
authors.forename: J A
authors.initials: JA
authors.lastname: Talbot
authors.forename: A C
authors.initials: AC
authors.lastname: Seguro
mesh_terms: D001427:Bacterial Toxins; D001938:Brazil; D002644:Chickenpox / Q000150:complications*; D002648:Child; D005098:Exotoxins / Q000235:genetics*; D017809:Fatal Outcome; D005798:Genes, Bacterial / Q000235:genetics*; D006801:Humans; D008297:Male; D012772:Shock, Septic / Q000209:etiology / Q000382:microbiology* / Q000473:pathology; D013290:Streptococcal Infections / Q000150:complications*; D013297:Streptococcus pyogenes / Q000472:pathogenicity; D013577:Syndrome; D014774:Virulence
chemical_list: D001427:Bacterial Toxins; D005098:Exotoxins