Streptogenic toxin shock syndromeA48.3

Author:Prof. Dr. med. Peter Altmeyer

All authors of this article

Last updated on: 29.10.2020

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Synonym(s)

Streptococcal toxic shock syndromes; Streptogenic toxin shock syndrome; STSS

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HistoryThis section has been translated automatically.

Willoughby 1986

PathogenThis section has been translated automatically.

streptococcus pyogenes

EtiopathogenesisThis section has been translated automatically.

Infection with toxin-producing strains of Streptococcus pyogenes. The streptococcal toxins SPE-A and -B are produced by S. pyogenes strains that form the M proteins 1, 3, 12 and 28. These proteins act as proteases and can lead to diffuse tissue destruction.

ManifestationThis section has been translated automatically.

Occurs in children and adults. In children, STSS cases can occur in conjunction with varicella that predispose to cutaneous streptococcal infections.

Clinical featuresThis section has been translated automatically.

In 80% of cases, begins as a local streptococcal infection of the skin with very painful diffuse redness and swelling and a regional lymphadenopathy(erysipelas or necrotizing fasciitis). Non-specific general symptoms such as general feeling of illness with high temperatures, vomiting and diarrhoea, myalgia and arthralgia. Development of a fluctuating phlegmonous inflammation; danger of the development of necrotising fasciitis.

Common concomitant symptom: scarlatiniform exanthema; also formation of haemorrhagic blisters. Within a few hours hypotension with renal failure and respiratory distress syndrome.

TherapyThis section has been translated automatically.

Intensive care therapy. Early surgical intervention with generous division of the phlegmonous area. Parenteral antibiotic therapy following an antibiogram, initially e.g. with a benzylpenicillin and clindamycin.

LiteratureThis section has been translated automatically.

  1. Chikkamuniyappa S (2004) Streptococcal toxic shock syndrome and sepsis manifesting in a patient with chronic rheumatoid arthritis. Dermatol Online J 10: 7
  2. Hashikawa S et al (2004) Characterization of group C and G streptococcal strains that cause streptococcal toxic shock syndrome. J Clin Microbiol 42: 186-192
  3. Patel RA et al (2004) Reduction in pediatric hospitalizations for varicella-related invasive group A streptococcal infections in the varicella vaccine era. J Pediatr 144: 68-74
  4. Zerr DM et al (1999) A case-control study of necrotizing fasciitis during primary varicella. Pediatrics 103: 783-790

Authors

Last updated on: 29.10.2020

Author: Prof. Dr. med. Peter Altmeyer