Shimizu Y, Sakashita H, Takada C, Otsuka Y, Ooe K, Tsumita R
Department of Anaesth, Asahi General Hospital.
Kansenshogaku Zasshi. 1994 Sep;68(9):1113-6. doi: 10.11150/kansenshogakuzasshi1970.68.1113.
A case of streptococcal toxic shock-like syndrome in a previously healthy, 57 year old Japanese female has been reported. Initially, she had a sore throat and low grade fever for 5 days. Because of sudden severe pain on the extremities and erythema on bilateral forearms, she was hospitalized. On admission, her conciousness was clear. Although profound hypotension, anuria and prolonged blood coagulation were observed. Antibiotics, fluid therapy and dopamine were given. Four hours after admission, she died in spite of resuscitation efforts, by sudden cardiac arrest. Streptococcus pyogenes was isolated in her blood. At the same time as when she died, three of the five people of the patient's family living with her, had pharingitis or pneumonia. From the pharynxs of the three people with pharingitis, Streptococcus pyogenes was also isolated. The serotype of all organisms was T11, and they produced exotoxintype B in vitro. This case suggests that infection of Streptococcus pyogenes is not essential for the development of toxic shock-like syndrome.
据报道，一名57岁既往健康的日本女性患链球菌中毒性休克样综合征。起初，她咽痛、低热5天。因四肢突发剧痛及双侧前臂红斑而住院。入院时，她意识清醒。尽管观察到严重低血压、无尿及凝血时间延长，但给予了抗生素、液体治疗及多巴胺。入院4小时后，尽管进行了复苏努力，她仍因心脏骤停突然死亡。在她血液中分离出化脓性链球菌。在她死亡的同时，与她一起生活的五名家庭成员中有三人患咽炎或肺炎。从三名患咽炎者的咽部也分离出化脓性链球菌。所有菌株的血清型均为T11，且它们在体外产生B型外毒素。该病例提示，化脓性链球菌感染并非中毒性休克样综合征发生的必要条件。
