一名绝经后女性因坏死性盆腔炎继发A组链球菌中毒性休克综合征。
Group A streptococcal toxic shock syndrome secondary to necrotizing pelvic inflammatory disease in a postmenopausal woman.
作者信息
Paulson Qiwei, Douglass Elizabeth, Moreno Alejandro, Aydelotte Jayson
机构信息
Department of Internal Medicine, University of Texas at Austin, Dell Medical School, Austin, TX, USA.
Department of Internal Medicine, University of Texas at Austin, Dell Medical School, Austin, TX, USA; Division of Infectious Diseases, University of Texas at Austin, Dell Medical School, Austin, TX, USA.
出版信息
IDCases. 2016 Mar 7;5:21-3. doi: 10.1016/j.idcr.2016.02.008. eCollection 2016.
Group A β-hemolytic streptococcus (GAS) is well known to cause upper respiratory tract or cutaneous infections, but some more virulent species of GAS can lead to a rapidly progressive life threatening soft tissue necrotizing infection and streptococcal toxic shock syndrome (STSS). In the modern era, GAS infections within the female reproductive tract leading to STSS are unusual and are often the result of retained products of conception or intrauterine devices. This report describes a case of GAS necrotizing pelvic infection in a previously healthy menopausal woman with no obvious portal of entry. Her clinical course rapidly progressed to septic shock and multiorgan failure. She required multiple surgeries in addition to targeted antimicrobials and aggressive management of shock and organ failures. After a prolonged hospital stay, she had a full recovery.
A组β溶血性链球菌（GAS）众所周知可引起上呼吸道或皮肤感染，但一些毒性更强的GAS菌株可导致迅速进展的、危及生命的软组织坏死性感染和链球菌中毒性休克综合征（STSS）。在现代，女性生殖道内导致STSS的GAS感染并不常见，通常是由妊娠物残留或宫内节育器引起的。本报告描述了一例既往健康的绝经后女性发生GAS坏死性盆腔感染的病例，该患者没有明显的感染入口。她的临床病程迅速进展为感染性休克和多器官功能衰竭。除了针对性的抗菌治疗以及对休克和器官功能衰竭进行积极处理外，她还需要多次手术。经过长时间住院治疗后，她完全康复。
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