Case Report | Open Access
Arthur Okere, David Schwartz, Philip Tierno, Patrick Schlievert, Randa Hamadeh, "Severe Invasive Group A Streptococcal Disease with Rhabdomyolysis but without Evidence of Shock or Local Myositis", Scholarly Research Exchange, vol. 2009, Article ID 786451, 3 pages, 2009. https://doi.org/10.3814/2009/786451
Severe Invasive Group A Streptococcal Disease with Rhabdomyolysis but without Evidence of Shock or Local Myositis
We report a presentation in an adult with Streptococcus pyogenes bacteremia and invasive tissue disease with rhabdomyolysis, but without evidence of toxic shock syndrome or local myonecrosis. We thus investigated how this infecting strain differed from strains known to cause toxic shock syndrome.
- E. M. Adams, S. Gudmundsson, D. E. Yocum, R. C. Haselby, W. A. Craig, and W. R. Sundstrom, “Streptococcal myositis,” Archives of Internal Medicine, vol. 145, no. 6, pp. 1020–1023, 1985.
- K. Belani, P. Schlievert, E. L. Kaplan, and P. Ferrieri, “Association of exotoxin-producing group A streptococci and severe disease in children,” Pediatric Infectious Disease Journal, vol. 10, no. 5, pp. 351–354, 1991.
- P. Schlievert, personal communication, Department of Microbiology, University of Minnesota.
- A. L. Bisno and D. L. Stevens, “Streptococcal infections in skin and soft tissues,” The New England Journal of Medicine, vol. 334, no. 4, pp. 240–245, 1996.
- P. Schlievert, “Role of superantigens in human disease,” Journal of Infectious Diseases, vol. 167, no. 5, pp. 997–1002, 1993.
- B. L. Kotzin, “Superantigens and their role in disease,” Hospital Practice, vol. 29, no. 11, pp. 59–63, 68–70, 1994.
- “Defining the group A streptococcal toxic shock syndrome: rationale and consensus definition. The Working Group on Severe Streptococcal Infections,” The Journal of the American Medical Association, vol. 269, no. 3, pp. 390–391, 1993.
- A. R. Hauser, D. L. Stevens, E. L. Kaplan, and P. Schlievert, “Molecular analysis of pyrogenic exotoxins from Streptococcus pyogenes isolates associated with toxic shock-like syndrome,” Journal of Clinical Microbiology, vol. 29, no. 8, pp. 1562–1567, 1991.
- D. R. Johnson, D. L. Stevens, and E. L. Kaplan, “Epidemiologic analysis of group A streptococcal serotypes associated with severe systemic infections, rheumatic fever, or uncomplicated pharyngitis,” Journal of Infectious Diseases, vol. 166, no. 2, pp. 374–382, 1992.
- J. M. Musser, A. R. Hauser, M. H. Kim, P. Schlievert, K. Nelson, and R. K. Selander, “Streptococcus pyogenes causing toxic-shock-like syndrome and other invasive diseases: clonal diversity and pyrogenic exotoxin expression,” Proceedings of the National Academy of Sciences of the United States of America, vol. 88, no. 7, pp. 2668–2672, 1991.
- B. Schwartz, R. R. Facklam, and R. F. Breiman, “Changing epidemiology of group A streptococcal infection in the USA,” The Lancet, vol. 336, no. 8724, pp. 1167–1171, 1990.
- D. L. Stevens, M. H. Tanner, J. Winship et al., “Reappearance of scarlet fever toxin A among streptococci in the Rocky Mountain West: severe group A streptococcal infections associated with a toxic shock-like syndrome,” The New England Journal of Medicine, vol. 321, pp. 1–7, 1989.
- E. T. Gaworzewska and G. Coleman, “Correspondence: group A streptococcal infections and a toxic shock-like syndrome,” The New England Journal of Medicine, vol. 321, p. 1546, 1989.
- B. Stegmayr, S. Björck, S. Holm, J. Nisell, A. Rydvall, and B. Settergren, “Septic shock induced by group A streptococcal infection: clinical and therapeutic aspects,” Scandinavian Journal of Infectious Diseases, vol. 24, no. 5, pp. 589–597, 1992.
- J. A. Mollick, G. G. Miller, J. M. Musser, R. G. Cook, D. Grossman, and R. R. Rich, “A novel superantigen isolated from pathogenic strains of Streptococcus pyogenes with aminoterminal homology to staphylococcal enterotoxins B and C,” The Journal of Clinical Investigation, vol. 92, no. 2, pp. 710–719, 1993.
- M. Iwasaki, H. Igarashi, Y. Hinuma, and T. Yutsudo, “Cloning, characterization and overexpression of a Streptococcus pyogenes gene encoding a new type of mitogenic factor,” FEBS Letters, vol. 331, no. 1-2, pp. 187–192, 1993.
- A. Norrby-Teglund, D. Newton, M. Kotb, S. E. Holm, and M. Norgren, “Superantigenic properties of the group A streptococcal exotoxin SpeF (MF),” Infection and Immunity, vol. 62, no. 12, pp. 5227–5233, 1994.
- G. A. Bohach, D. J. Fast, R. D. Nelson, and P. Schlievert, “Staphylococcal and streptococcal pyrogenic toxins involved in toxic shock syndrome and related illnesses,” Critical Reviews in Microbiology, vol. 17, no. 4, pp. 251–272, 1990.
- D. L. Murray, D. H. Ohlendorf, and P. Schlievert, “Staphylococcal and streptococcal superantigens: their role in human disease,” ASM News, vol. 61, no. 5, pp. 229–235, 1995.
- J. Kuby, Immunology, W. H. Freeman, New York, NY, USA, 2nd edition, 1994.
- V. Hríbalová, “Streptococcus pyogenes and the toxic shock syndrome,” Annals of Internal Medicine, vol. 108, no. 5, p. 772, 1988.
Copyright © 2009 Arthur Okere 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.