A Case of Severe Necrotizing Cellulitis Caused by Group G <I>Streptococcus dysgalactiae</I> subsp. <I>equisimilis</I>

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  • MISAWA Yoshiki
    Department of Infection Control and Prevention, The University of Tokyo Hospital Department of Biomolecular Science, Faculty of Sciences, Toho University
  • OKUGAWA Shu
    Department of Infection Control and Prevention, The University of Tokyo Hospital
  • UBUKATA Kimiko
    Kitasato Institute for Life Sciences, Kitasato University
  • OKUZUMI Katsuko
    Division of Infection Control, Department of Medical Safety Administration, Dokkyo University School of Medicine Hospital
  • OKADA Mitumasa
    Department of Biomolecular Science, Faculty of Sciences, Toho University
  • MORIYA Kyoji
    Department of Infection Control and Prevention, The University of Tokyo Hospital
  • KOIKE Kazuhiko
    Department of Infection Control and Prevention, The University of Tokyo Hospital

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Other Title
  • G群に凝集する<I>Streptococcus dysgalactiae</I> subsp. <I>equisimilis</I>による劇症型溶血レンサ球菌感染症の1例
  • 症例 G群に凝集するStreptococcus dysgalactiae subsp. equisimilisによる劇症型溶血レンサ球菌感染症の1例
  • ショウレイ Gグン ニ ギョウシュウ スル Streptococcus dysgalactiae subsp equisimilis ニ ヨル ゲキショウガタ ヨウケツ レンサ キュウキン カンセンショウ ノ 1レイ
  • A Case of Severe Necrotizing Cellulitis Caused by Group G Streptococcus dysgalactiae subsp. equisimilis

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Abstract

Group G streptococcus (GGS) is infrequently associated with severe invasive soft tissue infection and toxic shock syndrome. A 74-year-old woman with a history of lymphedema of the lower extremities after surgical and radiation therapy for uterine cancer and diabetic mellitus and admitted for swelling of the right leg, fever, and dyspnea. She presented with shock and necrotizing cellulitis of the right lower extremity. Laboratory tests showed leukocytepenia, acute renal and liver dysfunction, and muscle damage. She rapidly developed multiple organ failure and necrotizing cellulitis. A swab from skin vesicle, throat, and blood culture grew Group G Streptococcus dysgalactiae subsp. equisimilis. Despite endotoxin hemoadsorption therapy, administration of antibiotics, and intravenous immunoglobulin, she died 9 days after admission due to toxic shock syndrome caused by GGS. The M-protein gene (emm) typing of GGS isolated from both blood and skin lesion showed stG 485.0. Three virulence genes, sagA, slo and skcg, were detected from GGS isolated from them.

Journal

  • Kansenshogaku Zasshi

    Kansenshogaku Zasshi 80 (4), 436-439, 2006

    The Japanese Association for Infectious Diseases

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