Phlegmonous gastritis associated with group A streptococcal toxic shock syndrome.
Phlegmonous gastritis (PG) is a rare, acute, severe infectious disease of the gastric wall that is often fatal due to Streptococcus spp. A 77-year-old man with diabetes and a gastric ulcer was urgently admitted due to prolonged nausea and vomiting. Computed tomography revealed widespread diffuse thickening of the gastric wall, and PG was suspected. The patient expired less than 9 hours after admission despite intensive treatments. Later, an analysis of the blood and gastric juice revealed group A streptococcus (GAS) and virulence factors associated with toxic shock syndrome (TSS). We herein diagnosed a patient with an extremely aggressive course of PG caused by GAS TSS.
Department of Internal Medicine, Kinan Hospital, Japan.
Masaya
M
Morimoto
Shinobu
S
Tamura
Takahiro
T
Hayakawa
Hirofumi
H
Yamanishi
Chiaki
C
Nakamoto
Hiromichi
H
Nakamoto
Tadayoshi
T
Ikebe
Yoshio
Y
Nakano
Tokuzo
T
Fujimoto
D000368:Aged; D002481:Cellulitis / Q000209:etiology*; D003920:Diabetes Mellitus / Q000453:epidemiology; D005756:Gastritis / Q000000981:diagnostic imaging / Q000209:etiology*; D006801:Humans; D008297:Male; D012772:Shock, Septic / Q000150:complications* / Q000382:microbiology; D013276:Stomach Ulcer / Q000453:epidemiology; D013290:Streptococcal Infections / Q000150:complications*; D013297:Streptococcus pyogenes; D014057:Tomography, X-Ray Computed