Table of Contents Author Guidelines Submit a Manuscript
Canadian Journal of Infectious Diseases and Medical Microbiology
Volume 2016, Article ID 9463895, 5 pages
http://dx.doi.org/10.1155/2016/9463895
Case Report

Plantar Purpura as the Initial Presentation of Viridians Streptococcal Shock Syndrome Secondary to Streptococcus gordonii Bacteremia

1Department of Internal Medicine, Kaohsiung Armed Forces General Hospital, No. 2 Zhongzheng 1st Road, Lingya District, Kaohsiung 802, Taiwan
2Department of Cardiovascular Surgery, Kaohsiung Armed Forces General Hospital, No. 2 Zhongzheng 1st Road, Lingya District, Kaohsiung 802, Taiwan

Received 17 September 2015; Accepted 1 January 2016

Copyright © 2016 Chen-Yi Liao et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Viridians streptococcal shock syndrome is a subtype of toxic shock syndrome. Frequently, the diagnosis is missed initially because the clinical features are nonspecific. However, it is a rapidly progressive disease, manifested by hypotension, rash, palmar desquamation, and acute respiratory distress syndrome within a short period. The disease course is generally fulminant and rarely presents initially as a purpura over the plantar region. We present a case of a 54-year-old female hospital worker diagnosed with viridians streptococcal shock syndrome caused by Streptococcus gordonii. Despite aggressive antibiotic treatment, fluid hydration, and use of inotropes and extracorporeal membrane oxygenation, the patient succumbed to the disease. Early diagnosis of the potentially fatal disease followed by a prompt antibiotic regimen and appropriate use of steroids are cornerstones in the management of this disease to reduce the risk of high morbidity and mortality.