Achong Colleen, Chowdhury Tutul, Mustafa Fareeza, Smith David, Moussouris Harry
Internal Medicine, One Brooklyn Health, New York, USA.
Internal Medicine, Interfaith Medical Center, New York, USA.
Cureus. 2023 Aug 22;15(8):e43944. doi: 10.7759/cureus.43944. eCollection 2023 Aug.
Bullous impetigo leading to streptococcal toxic shock syndrome (STSS) immune activation and massive cytokine release is a rare condition. It has a significant mortality rate, which calls for quick diagnosis, early suspicion, and integrated treatment. Herein, we discuss the case of a 66-year-old man who underwent evaluation for leg swelling before quickly going into shock and experiencing respiratory failure, which necessitated invasive mechanical intubation. was identified by blood culture, and STSS was identified. Recommended antibiotics, intravenous (IV) immunoglobulin, and fluids made up the treatment regimen. In this case, the streptococcal infection deteriorated very quickly, and there was a rare relationship with bullous impetigo, which led to shock and respiratory failure. This case sheds lights on the need of having an early suspicion of this syndrome when a diabetic patient develops a skin lesion. A prompt diagnosis is necessary.
大疱性脓疱疮导致链球菌中毒性休克综合征（STSS）免疫激活和大量细胞因子释放是一种罕见病症。其死亡率很高，需要快速诊断、早期怀疑和综合治疗。在此，我们讨论一例66岁男性病例，该患者在迅速休克并出现呼吸衰竭之前接受了腿部肿胀评估，这需要进行有创机械通气。通过血培养确诊，诊断为STSS。治疗方案包括推荐使用的抗生素、静脉注射免疫球蛋白和补液。在该病例中，链球菌感染恶化非常迅速，且与大疱性脓疱疮存在罕见关联，导致休克和呼吸衰竭。该病例揭示了当糖尿病患者出现皮肤病变时早期怀疑这种综合征的必要性。必须迅速做出诊断。
