頸部初発の劇症型溶血性連鎖球菌感染症例

DOI Web Site 被引用文献1件 参考文献10件
  • 臼渕 肇
    自治医科大学附属さいたま医療センター耳鼻咽喉科
  • 太田 康
    自治医科大学附属さいたま医療センター耳鼻咽喉科
  • 金澤 丈治
    自治医科大学附属さいたま医療センター耳鼻咽喉科
  • 椿 恵樹
    自治医科大学附属さいたま医療センター耳鼻咽喉科
  • 飯野 ゆき子
    自治医科大学附属さいたま医療センター耳鼻咽喉科
  • 山田 茂樹
    自治医科大学附属さいたま医療センター臨床病理部

書誌事項

タイトル別名
  • A Case of Toxic Shock-like Syndrome due to Group A Streptococcal Infection of a Neck Lesion
  • ケイブ ショハツ ノ ゲキショウガタ ヨウケツセイ レンサ キュウキン カンセン ショウレイ

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Group A streptococci may cause a variety of infections, some of which are severe and may be lifethreatening. Patients affected by severe invasive group A streptococcal infection may develop a syndrome characterized by circulatory insufficiency with multiple organ failure, namely, streptococcal toxic shock-like syndrome (TSLS). Here, we report a case of streptococcal TSLS originating from the left neck. A 70-year-old man was referred to our hospital with a diagnosis of deep neck and mediastinal infection. Debridement of his left neck and drainage of anterior and posterior parts of the mediastinum were immediately performed. As Group A streptococci were detected from the effusion and blood, he was diagnosed as having streptococcal TSLS. Intensive systemic care involving long-term administration of penicillin G in addition to drainage of the infection helped him recover from TSLS. He underwent further debridement twice to control local infection. Early diagnosis of and surgical intervention for TSLS are mandatory. Subsequently, appropriate supportive treatment of vital organ dysfunction and administration of penicillin as the antibiotic of choice represent the cornerstones of the management of this syndrome.

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