van Dissel J T, Kullberg B J, van der Meer J W
Leids Universitair Medisch Centrum, afd. Infectieziekten, Leiden.
Ned Tijdschr Geneeskd. 1999 Jul 10;143(28):1452-5.
Since the mid-eighties an increase of severe infections with invasive group A streptococci (GAS) has been noticed throughout the world, not only in the elderly but in healthy adults as well. The acute presenting infection starts with fever, enanthema, generalised erythema, rapidly progressing into shock and multiorgan failure, and is called streptococcal toxic shock syndrome (STSS). Despite surgical and antibiotic therapy with penicillin and clindamycin the mortality is high. There are as yet insufficient data in patients with STSS to decide between penicillin en clindamycin. Intravenous administration of high dose gammaglobulin, advocated in the USA, might neutralize the exotoxins, but the effectiveness of this therapy has not been established yet.
自八十年代中期以来，全球范围内侵袭性A组链球菌（GAS）严重感染病例有所增加，不仅在老年人中，在健康成年人中也有出现。急性感染表现为发热、黏膜疹、全身性红斑，迅速发展为休克和多器官功能衰竭，这被称为链球菌中毒性休克综合征（STSS）。尽管采用了手术治疗以及青霉素和克林霉素的抗生素治疗，但死亡率仍然很高。对于STSS患者，目前尚无足够数据来决定是使用青霉素还是克林霉素。在美国提倡的静脉注射高剂量丙种球蛋白可能会中和外毒素，但这种疗法的有效性尚未得到证实。
