Refractory Toxic Shock-Like Syndrome from Streptococcus dysgalactiae ssp. equisimilis and Intravenous Immunoglobulin as Salvage Therapy: A Case Series.
Infections from Streptococcus dysgalactiae ssp. equisimilis (SDSE) can cause a wide variety of infections, ranging from mild cellulitis to invasive disease, such as endocarditis and streptococcal toxic shock-like syndrome (TSLS). Despite prompt and appropriate antibiotics, mortality rates associated with shock have remained exceedingly high, prompting the need for adjunctive therapy. IVIG has been proposed as a possible adjunct, given its ability to neutralize a wide variety of superantigens and modulate a dysregulated inflammatory response. We present the first reported cases of successful IVIG therapy for reversing shock in the treatment of SDSE TSLS.
Department of Medicine, Mount Sinai Beth Israel, New York, NY 10003, USA.
Marjan
0000-0002-8978-8978
M
Islam
Department of Medicine, Mount Sinai Beth Israel, New York, NY 10003, USA.
Dennis
D
Karter
Department of Pharmacy, Mount Sinai Beth Israel, New York, NY 10003, USA.
Jerry
J
Altshuler
Department of Pharmacy, NYU Langone Medical Center, New York, NY 10016, USA.
Diana
D
Altshuler
Department of Medicine, NYU Langone Medical Center, New York, NY 10016, USA; NYU School of Medicine, New York, NY 10016, USA.
David
D
Schwartz
Department of Cardiac Surgery, Mount Sinai Beth Israel, New York, NY 10003, USA.
Gianluca
G
Torregrossa