Surviving streptococcal toxic shock syndrome: a case report.
Surviving streptococcal toxic shock syndrome: a case report.
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存活的链球菌毒性休克综合征：病例报告。
DOI：
10.1186/1752-1947-1-118
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发表时间：
2007-10-29
影响因子：
1
通讯作者：
Smith, Ian C
中科院分区：
文献类型：
--
作者：
Madhusudhan, Thayur R;Sambamurthy, Srivatsa;Williams, Eileen;Smith, Ian C
尽管进行了积极的手术治疗，但由 A 组 β 溶血性链球菌化脓性链球菌引起的链球菌中毒性休克综合征和相关肌炎通常预后较差。由于临床特征不明确，最初常常会漏诊。发展到中毒状态的速度很快，除非尽早开始明确的治疗措施，否则最终结果可能是灾难性的。我们报告了一名先前健康的患者，该患者因 α 溶血性（草绿色）链球菌轻症而出现中毒性休克综合征，该患者通过抗生素、积极的重症监护支持（包括使用“脓毒症护理包”）、监测和持续的多学科审查成功治疗。在免疫能力正常的人中，由于轻链球菌引起的危及生命和肢体的紧急情况很少见，而且据我们所知，以前在英国科学文献中从未有过描述。只要保持高度怀疑并对患者进行严密监测，就有可能获得成功的结果。
Streptococcal toxic shock syndrome and associated myositis caused by group A beta-hemolytic streptococcus pyogenes generally have a poor outcome despite aggressive operative treatment. Frequently the diagnosis is missed initially as the clinical features are non-specific. The progression to a toxic state is rapid and unless definitive treatment measures are initiated early, the end result can be catastrophic. We report a previously healthy patient who had features of toxic shock syndrome due to alpha haemolytic (viridans) streptococcus mitis which was treated successfully with antibiotics, aggressive intensive care support including the use of a 'sepsis care bundle', monitoring and continuous multidisciplinary review. Life and limb threatening emergencies due to streptococcus mitis in an immune-competent person are rare and to our knowledge, have not previously been described in the English scientific literature. Successful outcome is possible provided a high degree of suspicion is maintained and the patient is intensively monitored.