[Multifocal inflammatory syndrome after invasive infection due to an M1 strain of Streptococcus pyogenes].
We report on a case of Streptococcus pyogenes invasive disease with toxic shock syndrome due to an M1 strain producing SpeA and SmeZ superantigenic toxins. Post-streptococcal sequelae included several episodes of reactive arthritis and orchitis whose outcome was favorable with corticosteroid therapy. Invasive streptococcal infections are increasingly reported and may associate septic, toxinic, and immunological diseases. High-grade systemic inflammation may induce nonsuppurative complications and autoimmune diseases by molecular mimicry. Among them, reactive arthritis has been recognized as a separate entity from acute rheumatic fever and post-streptococcal orchitis has not been described before. Treatment should be quickly started and should be effective on the etiologic agent but also on its toxins due to the severity of the invasive infections associated with the spread of highly virulent bacterial clones and the potential development of multifocal nonsuppurative sequelae.
Filleron
A
A
Service de pédiatrie III, hôpital Arnaud-de-Villeneuve, centre hospitalier régional universitaire de Montpellier, 371, avenue du Doyen-Gaston-Giraud, 34295 Montpellier cedex 5, France.
Marchandin
H
H
Rodière
M
M
Jeziorski
E
E
D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000942:Antigens, Bacterial / Q000276:immunology*; D001168:Arthritis / Q000276:immunology; D001425:Bacterial Outer Membrane Proteins / Q000276:immunology*; D002352:Carrier Proteins / Q000276:immunology*; D002675:Child, Preschool; D004359:Drug Therapy, Combination; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D006931:Hyperbaric Oxygenation; D008297:Male; D009920:Orchitis / Q000276:immunology; D012772:Shock, Septic / Q000175:diagnosis / Q000382:microbiology* / Q000628:therapy; D013290:Streptococcal Infections / Q000175:diagnosis / Q000276:immunology* / Q000382:microbiology / Q000628:therapy; D013297:Streptococcus pyogenes / Q000145:classification / Q000276:immunology*; D016896:Treatment Outcome
D000900:Anti-Bacterial Agents; D000942:Antigens, Bacterial; D001425:Bacterial Outer Membrane Proteins; D002352:Carrier Proteins; D005938:Glucocorticoids; C014689:streptococcal M protein