STSS by <i>Streptococcus pyogenes emm</i>22 genotype accompanied by CsrS mutation: A case report.
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- Ogawa Kaoru
- Altitude Emergency and Critical Care Medical, Saitama Red Cross Hospital, Japan
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- Kamiyama Jiro
- Altitude Emergency and Critical Care Medical, Saitama Red Cross Hospital, Japan
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- Ikebe Tadayoshi
- Department of Bacteriology I, National Institute of Infectious Diseases, Japan
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- Taguchi Shigemasa
- Altitude Emergency and Critical Care Medical, Saitama Red Cross Hospital, Japan
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- Kiyota Kazuya
- Altitude Emergency and Critical Care Medical, Saitama Red Cross Hospital, Japan
抄録
<p>The patient was a 22-year-old woman with no comorbidities who was transferred to our hospital due to cardiac arrest. Treatment enabled return to spontaneous circulation in the patient before arriving at the hospital. At the hospital, the patient’s vital signs were unstable. Vasopressors and hyperhydration therapy were administered. Computed Tomography (CT) showed no remarkable change that caused the cardiac arrest. Antibiotics were prescribed after a blood culture exam. The patient was admitted to the ICU. In the ICU, the high-capacity vasopressors, hyperhydration therapy and transfusion of fresh frozen plasma were continued. Two hours after examining the blood culture, the results remained positive. Gram staining revealed Streptococcus, and the antibiotics were switched to penicillin G potassium, clindamycin and immunoglobulin was added. Hyperhydration therapy caused respiratory failure. Ten hours after admission to the ICU, extracorporeal membrane oxygenation was introduced, but the patient’s general status did not improve. The patient died at 40 hours after admission. Blood culture results proved Streptococcus pyogenes; T and M serotypes were unclassifiable. The emm genotype was emm22. Regarding fever toxin genes, speA and speB were positive, and speC was negative. Among CsrS, CsrR and Rgg amino acid sequences, mutations in CsrS were detected.</p>
収録刊行物
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- Japanese Journal of Infectious Diseases
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Japanese Journal of Infectious Diseases advpub (0), 2024-02-29
国立感染症研究所