Köhler W, Nestler J, Knöll H, Schneider J, Schau H P
Zentralinstitutes für Mikrobiologie und experimentelle Therapie Jena, DDR.
Z Gesamte Inn Med. 1989 Dec 15;44(24):725-31.
Report on the first case of streptococcal toxic shock syndrome in the GDR. The patient was a 54-year-old female. One week before admission to the hospital she cut her finger. The day before admission to the hospital she presented with a painful left shoulder. Demarcation followed, and Streptococcus pyogenes (group A streptococci) was isolated from this area. The temperature rose to more than 40 degrees C and she became confused, hypotensive and anuric. There was evidence for disseminated intravascular coagulation. She died 23 h after admission. Clinical course and laboratory parameters resembles staphylococcal toxic shock syndrome, except a diarrhoea. The streptococcal strain produced a large amount of erythrogenic toxin type B (more than 20 ng/ml), but not erythrogenic toxins A or C. Erythrogenic toxins of Streptococcus pyogenes seem to play the same role in the development of streptococcal toxic shock syndrome as the toxic shock syndrome 1 (TSST-1) in staphylococcal toxic shock syndrome.
民主德国首例链球菌中毒性休克综合征报告。患者为一名54岁女性。入院前一周她割伤了手指。入院前一天，她出现左肩部疼痛。随后出现界限分明的症状，从该部位分离出化脓性链球菌（A组链球菌）。体温升至40多摄氏度，她变得神志不清、血压降低且无尿。有弥散性血管内凝血的证据。入院23小时后她死亡。临床病程和实验室参数与葡萄球菌中毒性休克综合征相似，只是没有腹泻。该链球菌菌株产生了大量B型致热外毒素（超过20纳克/毫升），但没有A或C型致热外毒素。化脓性链球菌的致热外毒素在链球菌中毒性休克综合征的发展中似乎与葡萄球菌中毒性休克综合征中的中毒性休克综合征毒素1（TSST - 1）发挥相同作用。
