Saldías Fernando, Yáñez Jorge, Saldías Velia, Díaz Orlando
Departamento de Enfermedades Respiratorias, Pontificia Universidad Catolica de Chile, Santiago, Chile.
Rev Med Chil. 2008 Dec;136(12):1564-9. Epub 2009 Mar 23.
During the past two decades there has been a resurgence of invasive group A streptococcal (GAS) infection, specially pneumonia and bacteremia. We report a 35 year-old female previously subjected to a thyroidectomy for a thyroid cancer, that five days after operation, presented with a severe community-acquired pneumonia caused by Streptococcus pyogenes (Lancefield Group A Streptococcus) that was complicated by acute respiratory failure and septic shock. She was treated with a combination of 3 g/day of cefotaxime and 1.8 g/day of clindamycin with a good clinical response and discharged from the hospital in good conditions. Although this microorganism is an uncommon cause of community-acquired pneumonia, previously healthy individuals may be infected and the clinical course may be fulminant. Patients with invasive GAS infection admitted to ICU have a high mortality rate. Treatment of choice of Group A streptococcal infection is penicillin. However, clindamycin should be added in severe infections .
在过去二十年中，侵袭性A组链球菌（GAS）感染有所复发，尤其是肺炎和菌血症。我们报告一例35岁女性，此前因甲状腺癌接受了甲状腺切除术，术后五天出现由化脓性链球菌（兰斯菲尔德A组链球菌）引起的严重社区获得性肺炎，并并发急性呼吸衰竭和感染性休克。她接受了每日3克头孢噻肟和每日1.8克克林霉素联合治疗，临床反应良好，出院时状况良好。尽管这种微生物是社区获得性肺炎的罕见病因，但先前健康的个体也可能被感染，且临床病程可能呈暴发性。入住重症监护病房的侵袭性GAS感染患者死亡率很高。A组链球菌感染的首选治疗药物是青霉素。然而，严重感染时应加用克林霉素。
