title: Multi-organ failure in a previously healthy 10-year-old boy: streptococcal toxic shock syndrome (STSS) - a rare differential diagnosis.
abstract: Streptococcal Toxic Shock Syndrome (STSS) is a severe toxin-mediated disease with acute onset. A previously healthy 10-year-old boy presented with abdominal pain, vomiting, diarrhoea and fever for 3 days. He was admitted with signs of an acute abdomen. A treatment with ibuprofen had been started before admission. The child developed a multi-organ failure with persistent hematuria, persistent fever, ascites, pericardial and pleural effusions. Intensive microbial and viral analysis did not result in any relevant finding. Detection by PCR of DNA of the streptococcal super-antigens speM and speL supported the diagnosis of STSS. After an intensive-care treatment of 4 weeks according to international critical-care guidelines the child could be discharged without residuals.
authors.affiliation: Marien-Hospital Witten gGmbH, Kinderklinik, Schwerpunkt Neonatologie/Pädiatrische Intensivmedizin, Witten, Germany. Bettina@Meedt.de
authors.forename: B
authors.initials: B
authors.lastname: Meedt
authors.forename: B
authors.initials: B
authors.lastname: Gharavi
authors.forename: M
authors.initials: M
authors.lastname: Imöhl
authors.forename: J-C
authors.initials: JC
authors.lastname: Becker
mesh_terms: D000006:Abdomen, Acute / Q000209:etiology; D001426:Bacterial Proteins / Q000235:genetics; D002648:Child; D003422:Critical Care; D003937:Diagnosis, Differential; D006801:Humans; D008297:Male; D009102:Multiple Organ Failure / Q000175:diagnosis* / Q000209:etiology* / Q000382:microbiology; D016133:Polymerase Chain Reaction; D012772:Shock, Septic / Q000175:diagnosis* / Q000382:microbiology; D013290:Streptococcal Infections / Q000175:diagnosis* / Q000382:microbiology; D013297:Streptococcus pyogenes / Q000235:genetics; D018089:Superantigens / Q000235:genetics
chemical_list: D001426:Bacterial Proteins; C469921:SpeM protein, Streptococcus pyogenes; D018089:Superantigens; C457360:speL protein, Streptococcus pyogenes