Natoli S, Fimiani C, Faglieri N, Laurenzi L, Calamaro A, Frasca A M, Arcuri E
Intensive Care Unit and Pain Therapy, Regina Elena Cancer Institute, Roma, Italy.
Intensive Care Med. 1996 Sep;22(9):985-9. doi: 10.1007/BF02044129.
Streptococcal toxic shock-like syndrome is a life-threatening illness which is on the increase. In early reports, only group A beta-hemolytic streptococcus was associated with the disease, but recent evidence indicates non-A streptococci groups are also involved.
We describe the first reported case of streptococcal toxic shock-like syndrome caused by a group C strain in Italy. Prior to the disease, the patient, a 46-year-old man, had been in good health and had only a 3-day history of sore throat, low grade fever, vomiting, diarrhea, and myalgia before admission. Initially, diagnosis was based only on clinical evidence: shock, multiorgan failure, profound hypothermia, and no apparent signs of infection. Toxic cardiomyopathy was also present.
Positive throat swab and blood culture confirmed a "definite case" following established criteria. Anamnesis showed a diagnosis of monoclonal gammopathy. Antibiotic treatment was begun immediately on admission of the patient, who was discharged 20 days later in good health.
This case illustrates how an early diagnosis and prompt antibiotic therapy can determine a more favorable outcome.
链球菌中毒性休克样综合征是一种日益增多的危及生命的疾病。在早期报告中，只有A组β溶血性链球菌与该疾病相关，但最近的证据表明非A组链球菌也与之有关。
我们描述了意大利首例由C组菌株引起的链球菌中毒性休克样综合征报告病例。发病前，该患者为一名46岁男性，身体健康，入院前仅有3天的咽痛、低热、呕吐、腹泻和肌痛病史。最初，诊断仅基于临床证据：休克、多器官功能衰竭、体温过低且无明显感染迹象。还存在中毒性心肌病。
咽喉拭子和血培养呈阳性，根据既定标准确诊为“确诊病例”。既往史显示诊断为单克隆丙种球蛋白病。患者入院后立即开始抗生素治疗，20天后康复出院。
该病例说明了早期诊断和及时的抗生素治疗如何能带来更有利的结果。
