A fatal case of streptococcal toxic shock syndrome due to Streptococcus dysgalactiae subsp. equisimilis possibly caused by an intramuscular injection.
An 88-year-old man died of streptococcal toxic shock syndrome due to a group G streptococcus infection that was possibly caused by an intramuscular injection given 30 hours earlier in his right deltoid muscle. The causative pathogen was later identified to be Streptococcus dysgalactiae subsp. equisimilis (stG485). Although providing intramuscular injections is an essential skill of health care workers that is performed daily worldwide, it may constitute a port of entry for pathogens via skin breaches that can cause life-threatening infections. All invasive procedures should be carefully performed, especially when immunologically compromised patients are involved.
Emergency Unit and Critical Care Center, Tsuyama Central Hospital, Japan. e_dai_for_all@hotmail.com
Hideharu
H
Hagiya
Shunji
S
Okita
Yasutoshi
Y
Kuroe
Hiroyoshi
H
Nojima
Shinkichi
S
Otani
Junichi
J
Sugiyama
Hiromichi
H
Naito
Susumu
S
Kawanishi
Shingo
S
Hagioka
Naoki
N
Morimoto
D000368:Aged; D000369:Aged, 80 and over; D000701:Analgesics, Opioid / Q000008:administration & dosage; D000942:Antigens, Bacterial / Q000235:genetics; D016470:Bacteremia / Q000209:etiology / Q000382:microbiology; D001425:Bacterial Outer Membrane Proteins / Q000235:genetics; D002352:Carrier Proteins / Q000235:genetics; D017809:Fatal Outcome; D006801:Humans; D007273:Injections, Intramuscular / Q000009:adverse effects*; D008297:Male; D010423:Pentazocine / Q000008:administration & dosage; D012772:Shock, Septic / Q000209:etiology* / Q000382:microbiology; D013290:Streptococcal Infections / Q000209:etiology* / Q000382:microbiology; D013291:Streptococcus / Q000235:genetics / Q000302:isolation & purification / Q000472:pathogenicity
D000701:Analgesics, Opioid; D000942:Antigens, Bacterial; D001425:Bacterial Outer Membrane Proteins; D002352:Carrier Proteins; C014689:streptococcal M protein; D010423:Pentazocine