Mori Takeo, Yoshizawa Sadako, Onda Naoki, Mifune Yamato, Sugo Fumio, Kashiwagi Katsuhito, Sato Takahiro, Maeda Tadashi, Takemoto Norihiko, Sasaki Yosuke
Department of General Medicine and Emergency Care (Infectious Diseases), Toho University Omori Medical Center, Tokyo, JPN.
Department of Microbiology and Infectious Diseases, Toho University School of Medicine, Tokyo, JPN.
Cureus. 2025 Sep 17;17(9):e92592. doi: 10.7759/cureus.92592. eCollection 2025 Sep.
Invasive group A streptococcal infection (iGAS) can develop rapidly in immunocompromised individuals. We describe the case of a 66-year-old man with multiple myeloma who was admitted for chemotherapy and subsequently developed iGAS. He had been performing nasal self-packing with facial tissue for nasal discharge and hemorrhage. During hospitalization, he developed erythema, pain, and swelling around the nose and experienced a sudden onset of septic shock characterized by profound hypotension requiring norepinephrine infusion. was detected in blood cultures, and treatment with beta-lactam antibiotics and clindamycin led to rapid improvement. Follow-up testing revealed that typing identified the strain as . This case highlights that in immunocompromised individuals, trivial self-care like nasal self-packing can precipitate severe infections such as iGAS and shock, emphasizing the need for clinical vigilance.
侵袭性A组链球菌感染（iGAS）在免疫功能低下的个体中可能迅速发展。我们描述了一名66岁的多发性骨髓瘤男性患者的病例，他因化疗入院，随后发生了iGAS。他一直在用面巾纸自行填塞鼻腔以处理鼻分泌物和出血。住院期间，他鼻子周围出现红斑、疼痛和肿胀，并突然发生感染性休克，其特征为严重低血压，需要输注去甲肾上腺素。血培养检测到[具体病菌名称未给出]，使用β-内酰胺类抗生素和克林霉素治疗后病情迅速改善。后续检测显示，[病菌分型检测]鉴定该菌株为[具体菌株类型未给出]。该病例突出表明，在免疫功能低下的个体中，像鼻腔自行填塞这样的日常自我护理可能引发诸如iGAS和休克等严重感染，强调了临床警惕的必要性。
