[Case report of toxic shock-like syndrome due to group A streptococcal infection].
[Case report of toxic shock-like syndrome due to group A streptococcal infection].
复制标题
A群链球菌感染致中毒性休克样综合征一例报告[J].
DOI：
10.11150/kansenshogakuzasshi1970.67.236
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发表时间：
1993
期刊：
影响因子：
--
通讯作者：
Y. Ookochi
中科院分区：
文献类型：
--
作者：
Y. Shimizu;A. Ohymama;K. Kasama;M. Miyazaki;K. Ooe;Y. Ookochi
报告1例链球菌中毒性休克综合征，患者为44岁健康的日本男性。他最初的症状是喉咙痛、低烧、腹泻和双腿轻微疼痛。此后不久，他迅速出现高烧、严重低血压、多灶性表皮坏死，以及严重的化脓性筋膜炎和肌炎，这需要双腿在膝盖以上截肢。后来，尽管接受了治疗，他还是出现了弥漫性血管内凝血症、成人呼吸窘迫综合征、急性肾功能衰竭、昏迷以及手臂和外生殖器的坏死性炎症。他在第13个住院日去世。从坏死肌和右膝关节分离出化脓性链球菌。该菌经鉴定为M3、T3，对青霉素类药物敏感，体外可产生链球菌化脓性外毒素A。这是日本首例链球菌中毒性休克综合征病例报告。
A case of streptococcal toxic shock like syndrome occurring in a 44-year-old previously healthy Japanese male is reported. He initially had a sore throat, low grade fever, diarrhea and mild pains in a lower extremities. Shortly thereafter, he rapidly developed a high fever, profound hypotension, multifocal epidermal necrosis, and sever purulent fasciitis and myositis in both lower extremities, which required above knee amputation of both legs. He later developed disseminated intravascular coagulopathy, adult respiratory distress syndrome, acute renal failure, coma and necrotizing inflammation of both arms and external genitalia despite treatment. He died on the 13th hospital day. Streptococcus pyogenes was isolated from the necrotic muscles and right knee joint. The organism was typed as M3, T3, was sensitive to penicillins, and was found to be producing streptococcal pyogenic exotoxin A in vitro. This is the first case report of streptococcal toxic shock like syndrome in Japan.