engleski

Toxic shock syndrome due to group A streptococcal pharyngitis and bacteremia in adults

Bacteremia and/or toxic shock syndrome are rare complications of streptococcal pharyngitis in adults. This report describes a previously healthy young man with streptoccocal toxic shock syndrome who presented with fatigue, high fever, and suspected extensive streptoccocal tonsillo-pharyngitis. Treatment consisted of high-dose antibiotics followed by therapy of consumptive coagulopathy, acute renal failure, and toxic shock syndrome. An attempt at hemodialysis and hemodiafiltration was ineffective, and the patient died within 24 h of admission. The autopsy findings were compatible with the clinical diagnosis. The invasive group A streptococci isolated from the pharyngeal swab and blood cultures were identified as M1 and T1 type with pyrogenic exotoxin genes A and B. This was a definite case of streptococcal toxic shock syndrome complicated with multiorgan failure and lethal outcome. The benefit of intravenous immunoglobulins, surgical intervention, or clindamycin for improving survival remain to be evaluated.

pharyngitis; shock septicus; Streptococcus pyogenes

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