Christen R D, Moser R, Schlup P, Neftel K A
Department of Medicine, University of California, San Diego.
Klin Wochenschr. 1990 Apr 17;68(8):427-30. doi: 10.1007/BF01648585.
We describe two female patients presenting with spontaneous peritonitis and fulminant Streptococcus pyogenes (Strep. pyogenes) septicemia and shock. Both patients recovered completely upon immediate antibiotic therapy, initially with broad range combination therapy effective against Strep. pyogenes, which was switched to penicillin G when culture results became available. This isolated strain in case 1 was M-type 28, which is the M-type most often isolated from vaginal swabs (as commensal) and from blood from patients with puerperal sepsis. Patient 1 had signs and symptoms of a toxic shock-like syndrome, including rapid onset of fever and shock, skin rash, desquamation of palms and soles, and multisystem involvement with vomiting, diarrhea, myalgia, renal failure, and severe disorientation without focal neurological deficits.
我们描述了两名女性患者，她们表现为自发性腹膜炎、暴发性化脓性链球菌败血症和休克。两名患者在立即接受抗生素治疗后均完全康复，最初采用对化脓性链球菌有效的广谱联合治疗，培养结果出来后改用青霉素G。病例1中的分离菌株为M型28，这是最常从阴道拭子（作为共生菌）和产褥期败血症患者血液中分离出的M型。患者1有中毒性休克样综合征的体征和症状，包括发热和休克迅速发作、皮疹、手掌和脚底脱皮，以及多系统受累，伴有呕吐、腹泻、肌痛、肾衰竭和严重定向障碍但无局灶性神经功能缺损。
