López Alvarez J M, Valerón Lemaur M E, Consuegra Llapur E, Urquía Martí L, Morón Saén de Casas A, González Jorge R
Unidad de Medicina Intensiva Pediátrica, Complejo Hospitalario Universitario Insular-Materno Infantil, Las Palmas de Gran Canaria, España.
Med Intensiva. 2007 Mar;31(2):100-3. doi: 10.1016/s0210-5691(07)74782-4.
Three cases of children admitted to the Pediatric Intensive Medicine Unit in the months of February to March 2004 with the diagnosis of streptococcal toxic shock syndrome are presented. Two were under 2 years of age and the initial symptoms suggested viriasis. They evolved towards septic shock with early multiorganic failure and then death due to massive hemoptysis, ventricular fibrillation due to hyperkaliemia. Streptococcus pyogenes with serotypes M1T1 was isolated in all the cases and the patients had the clinical criteria of streptococcal toxic shock syndrome. Their course was unfavorable in spite of the resuscitation steps, early antibiotic treatment and artificial support of the different organic failures. We stress the rareness of the cases, early age, its appearance in a short period of time, its sudden onset and the null response to treatment initiated.
本文报告了2004年2月至3月期间收入儿科重症监护病房的3例诊断为链球菌中毒性休克综合征的儿童病例。其中2例年龄在2岁以下，最初症状提示病毒感染。病情发展为感染性休克，早期出现多器官功能衰竭，随后因大量咯血、高钾血症导致心室颤动而死亡。所有病例均分离出M1T1血清型的化脓性链球菌，患者符合链球菌中毒性休克综合征的临床标准。尽管采取了复苏措施、早期抗生素治疗以及对不同器官功能衰竭进行人工支持，但其病程仍不乐观。我们强调了这些病例的罕见性、低龄、在短时间内出现、突然起病以及对所启动治疗的无反应。
