A case report of pregnancy-related STSS with false-negative result in the rapid antigen test

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  • A群レンサ球菌簡易検査が陰性であったが劇症型A群レンサ球菌感染症「分娩型」として加療し母児共に救命できた1例

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Abstract

<p> Group A streptococcal（GAS）toxic shock syndrome（TSS）is an acute life-threatening illness that causes septic shock and uterine circulatory failure. We report a rare case of a primigravida who developed GAS TSS in the third trimester. We suspected GAS TSS from the clinical course and started treatment promptly, and we could save both the mother and baby.</p><p> A 36-year-old woman exhibited fever and genital bleeding at 31 weeks of gestation upon presentation at our hospital. A cesarean section was performed due to non-reassuring fetal status. The neonate was a male weighing 2,238 g with Apgar scores of 5 and 8 at 1 and 5 min, respectively.</p><p> The mother received a blood transfusion and treatment for disseminated intravascular coagulation during surgery.</p><p> After surgery, her blood pressure decreased, tachycardia and respiratory failure were seen. She was strongly suspected of having GAS TSS, so antibiotic treatment was started. She was then transfer to a tertiary medical center. GAS was detected blood and endometrial swab cultures. After making good progress, the mother and neonate were discharged from the hospital. This case demonstrates that GAS TSS should be considered in the differential diagnosis of pregnant patients presenting with fever and rapid onset of septic shock.</p>

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