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Streptococcal toxic shock syndrome – a life-threatening condition caused by various streptococcal species


Authors: H. Bartoš;  L. Fabianová;  P. Dlouhý
Authors‘ workplace: Infekční oddělení Masarykovy nemocnice v Ústí nad Labem
Published in: Epidemiol. Mikrobiol. Imunol. 67, 2018, č. 2, s. 82-86
Category: Short Communication

Overview

Streptococcal toxic shock syndrome (STSS) is an acute, life-threatening condition which presents as a rapid onset shock and multiorgan failure (multiorgan dysfunction syndrome, MODS). This communication summarizes the existing body of evidence and presents three case reports. In two patients, STSS was caused by the bacterium Streptococcus pyogenes and in one patient, Streptococcus dysgalactiae was identified as the causative agent. STSS cases caused by other streptococcal species have been reported less often in the literature. A number of articles and manuals (including the CDC definition from 2010) even continue to state that STSS can only be caused by group A streptococci (S. pyogenes) [1]. To our knowledge, the case report presented of STSS caused by another streptococcal species is the first report in the Czech literature.

Keywords:
oxic shock syndrome – Streptococcus pyogenesStreptococcus dysgalactiae


Sources

1. Streptococcal Toxic Shock Syndrome (STSS) (Streptococcus pyogenes) 2010 Case Definition [online]. [cit. 2017-02-16] Dostupné na www: <https://wwwn.cdc.gov/nndss/conditions/streptococcal-toxic-shock-syndrome/case-definition/2010>.

2. Tyll T, Bílková M, Revinová A, et al. Syndrom toxického šoku. Epidemiol. Mikrobiol. Imunol, 2015;64(4):210–220.

3. Infekce v České republice – EPIDAT [online]. 2016 [cit. 2017-02-16]. Dostupné na www: <www.szu.cz/publikace/data/kumulativni-nemocnost-vybranych-hlasenych-infekci-v-ceske-republice >.

4. Nei T, Akutsu K, Shima A, et al. A case of streptococcal toxic shock syndrome due to Group G streptococci identified as Streptococcus dysgalactiae subsp. equisimilis. J Infect Chemother, 2012;18(6):919–924.

5. Hashikawa S, Iinuma Y, Furushita M, et al. Characterization of group C and G streptococcal strains that cause streptococcal toxic shock syndrome. J Clin Microbiol, 2004; 42(1):186–192.

6. Reglinski M, Sriskandan S. The contribution of group A streptococcal virulence determinants to the pathogenesis of sepsis. Virulence, 2014;5(1):1–10.

7. Brosnahan A, Schlievert M. Gram Positive Bacterial Superantigen Outside-In Signaling Causes Toxic Shock Syndrome. FEBS J, 2011;278(23):4649–4667.

8. Stevens DL. Streptococcal Toxic-Shock syndrome: Spectrum of Disease, Pathogenesis, and new Concepts in Treatment. Emerg Infect Dis, 1995;1(3):69–78.

9. Stevens DL, Tanner MH, Winship J. Severe group A streptococcal infections associated with a toxic shock-like syndrome and scarlet fever toxin A. N Engl J Med, 1989;321(1):1–7.

Labels
Hygiene and epidemiology Medical virology Clinical microbiology
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