Department of Hematology and Oncology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-Ku, Tokyo, 113-8655, Japan.
Department of Infectious Diseases, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-Ku, Tokyo, 113-8655, Japan.
J Infect Chemother. 2023 Apr;29(4):407-409. doi: 10.1016/j.jiac.2022.12.001. Epub 2022 Dec 10.
Toxic shock-like syndrome (TSLS) is a life-threatening hyperinflammatory complication caused by Streptococcus species infections. We reported the first case of TSLS caused by primary bacteremia of Streptococcus agalactiae during chemotherapy for multiple myeloma. A 74-year-old woman, who received combination chemotherapy of elotuzumab, pomalidomide, and dexamethasone for treatment-refractory multiple myeloma, was transported to our hospital under comatose and septic shock. Her blood culture detected Streptococcus agalactiae, and considering the progressive multiorgan failure, she was diagnosed with TSLS. Empiric antibiotic treatment with meropenem and respiratory and circulatory support were quickly initiated, resulting in an almost complete recovery of organ functions. It should be noted that with the advances of chemotherapy, the risk of infection is becoming more diverse.
中毒性休克样综合征（TSLS）是由链球菌感染引起的危及生命的过度炎症性并发症。我们报告了首例由化脓性链球菌引起的 TSLS 病例，该患者在多发性骨髓瘤的化疗期间发生原发性菌血症。一名 74 岁女性，因治疗抵抗性多发性骨髓瘤接受依鲁替尼、泊马度胺和地塞米松联合化疗，在昏迷和感染性休克状态下被转运至我院。她的血培养检测到化脓性链球菌，考虑到进行性多器官衰竭，诊断为 TSLS。我们迅速开始使用美罗培南进行经验性抗生素治疗，并进行呼吸和循环支持，从而几乎完全恢复了器官功能。值得注意的是，随着化疗的进步，感染的风险变得更加多样化。
