Yuen W, Maartense E, Vreede R W
Afd. Interne Geneeskunde, Reinier de Graaf Gasthuis, Delft.
Ned Tijdschr Geneeskd. 1999 Jul 10;143(28):1474-7.
In two patients, a woman aged 34 and a man aged 38, toxic shock-like syndrome was diagnosed. This is a serious and potentially lethal disease characterized by multiorgan failure, fever, skin lesions and shock and caused by the exotoxin of Streptococcus pyogenes. Both patients had an invasive Lancefield group A beta haemolytic streptococcal infection. The first patient presented with a skin wound at the right knee and later developed shock and thrombosis, in the second a flu-like disease was complicated by respiratory insufficiency, rhabdomyolysis and acute renal insufficiency. Timely recognition of this infection may reduce the risk of complications such as adult respiratory distress syndrome, disseminated intravasal coagulation and necrotizing fasciitis. Both patients eventually recovered after antibiotic and intensive supporting therapy. This infection can be life-threatening and the fatality rate is 15-35% even if patients received appropriate antimicrobial therapy, supportive care, and, where necessary, surgical debridement.
在两名患者中，一名34岁女性和一名38岁男性，被诊断出患有中毒性休克样综合征。这是一种严重且可能致命的疾病，其特征为多器官功能衰竭、发热、皮肤病变和休克，由化脓性链球菌的外毒素引起。两名患者均患有侵袭性A群β溶血性链球菌感染。第一名患者右膝出现皮肤伤口，随后发展为休克和血栓形成，第二名患者类似流感的疾病并发呼吸功能不全、横纹肌溶解和急性肾功能不全。及时识别这种感染可降低诸如成人呼吸窘迫综合征、弥散性血管内凝血和坏死性筋膜炎等并发症的风险。两名患者在接受抗生素和强化支持治疗后最终康复。这种感染可能危及生命，即使患者接受了适当的抗菌治疗、支持性护理以及必要时的手术清创，死亡率仍为15%至35%。
