title: Streptococcus agalactiae toxic shock-like syndrome: two case reports and review of the literature.
abstract: We present 2 patients with Streptococcus agalactiae toxic shock-like syndrome and review another 11 well-reported cases from the literature. Streptococcal toxic shock-like syndrome is a devastating illness with a high mortality rate, therefore we stress the importance of early supportive management, antimicrobial therapy, and surgical intervention. Toxic shock-like syndrome is likely to be underestimated in patients with invasive Streptococcus agalactiae infection who present with shock. Early diagnosis requires high suspicion of the illness, along with a thorough mucocutaneous examination. Streptococcus agalactiae produces uncharacterized pyrogenic toxins, which explains the ability of the organism to cause toxic shock-like syndrome.
authors.affiliation: From the Department of Infectious Diseases (FAA, LA, SB, R Hanna, NR, ST), Pikeville Medical Center, Pikeville, Kentucky; Department of Infectious Diseases (R Hallit), Saint Michael's Medical Center, Newark, New Jersey; and University of Minnesota Medical School (PMS), Minneapolis, Minnesota.
authors.forename: Fadi
authors.initials: F
authors.lastname: Al Akhrass
authors.forename: Lina
authors.initials: L
authors.lastname: Abdallah
authors.forename: Steven
authors.initials: S
authors.lastname: Berger
authors.forename: Rami
authors.initials: R
authors.lastname: Hanna
authors.forename: Nina
authors.initials: N
authors.lastname: Reynolds
authors.forename: Shellie
authors.initials: S
authors.lastname: Thompson
authors.forename: Rabih
authors.initials: R
authors.lastname: Hallit
authors.forename: Patrick M
authors.initials: PM
authors.lastname: Schlievert
mesh_terms: D000368:Aged; D003920:Diabetes Mellitus; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D008875:Middle Aged; D012772:Shock, Septic / Q000175:diagnosis / Q000382:microbiology* / Q000628:therapy; D013290:Streptococcal Infections / Q000175:diagnosis / Q000382:microbiology* / Q000628:therapy; D013292:Streptococcus agalactiae / Q000302:isolation & purification*