Group A Streptococcal Meningitis and Toxic Shock-Like Syndrome in a Three-Month-Old Girl in Brazil

Sztajnbok, Jaques; Marotto, Paulo C. F.; Santos, Denise Langanke dos; Hidalgo, N. T. R.; Brandileone, Maria Cristina C.; Seguro, Antônio Carlos

doi:10.1097/00019048-199706070-00015

Cited by 3 publications

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“…A literatura mostra que a partir da década de 1980, houve aumento na freqüência de infecções graves associadas ao S. pyogenes, sobretudo quando induzidas pelas cepas M1, M3 e M18, consideradas de maior virulência 7 . Atualmente, acredita-se que os sorotipos M1 e M3 apresentem a capacidade de alterar a função fagocítica e induzir a produção de exotoxinas pirogênicas, principalmente a SpeA, que pode atuar como superantígeno 8 .…”

Section: Introductionunclassified

Meningite otogênica por Streptococcus pyogenes sorotipo M3

Person

Tanaka

Iwamoto

2008

Arq. Bras. Ciên. Saúde

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ResumoAtualmente, a meningite bacteriana constitui sério problema de saúde pública mundial. Sua incidência, aliada ao seu potencial de letalidade e seqüelas, torna a doença de extrema importância social, despertando o interesse dos profissionais de saúde quanto ao seu diagnóstico e tratamento precoces.Meningites causadas por Streptococcus pyogenes têm sido consideradas raras na literatura, sendo os sorotipos M1, M3 e M18 associados a maior virulência e elevado potencial de letalidade. O presente estudo tem como objetivo descrever um caso de paciente masculino de 14 anos de idade, com otite média aguda, que evoluiu com meningite por Streptococcus pyogenes, septicemia e óbito. As cepas de S. pyogenes isoladas de cultura de líquor e hemocultura foram submetidas à tipagem molecular pelos métodos Pulse-field gel electrophoresis (PFGE) e emm, identificando-se o sorotipo M3. Pôde-se concluir que, tratava-se de cepa potencialmente agressiva, freqüentemente associada a quadros fatais, com evolução a partir de otite média aguda supurada, doença bastante freqüente na comunidade. Os profissionais de saúde devem atentar para o aumento de infecções letais provocadas por esta bactéria, sendo altamente desejável o diagnóstico e tratamento precoces.Palavras-Chave: Meningite otogênica; otite média aguda; Streptococcus pyogenes; sepse. AbstractBacterial meningitis is a serious current public health problem worldwide. Its incidence and potential capacity to cause lethality and sequels turn the disease into a very important social problem, taking interest of health professionals to early diagnosis and treatment. Meningitis caused by Streptococcus pyogenes has been considered rare in the literature, and the serotypes M1, M3 and M18 are associated to high virulence, frequently causing death. The present study aims to report a case of a 14 year-old male patient with acute otitis media, followed with meningitis by Streptococcus pyogenes, sepsis and death. The strains of S. pyogenes isolated from cerebrospinal fluid culture and hemoculture were submitted to molecular typing using Pulse-field gel electrophoresis (PFGE) and emm methods, identifying serotype M3. We concluded that this strain is potentially aggressive, frequently associated with lethal infections, beginning with suppurate acute otitis media, a common infection in community. The health professionals should pay attention at the increase of lethal infections caused by this pathogen, being important the early diagnosis and treatment.

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Section: Introductionunclassified

Meningite otogênica por Streptococcus pyogenes sorotipo M3

Person

Tanaka

Iwamoto

2008

Arq. Bras. Ciên. Saúde

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Meningite neonatal por Streptococcus pyogenes e trombose de seio sagital: relato de caso

Krebs

Chieffi

Ceccon

et al. 1998

Arq. Neuro-Psiquiatr.

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RESUMO -Relatamos um caso de meningite por Streptococcus pyogenes em menina de 18 dias de vida, com evolução complicada por trombose de seio sagital. São discutidos alguns aspectos da patogênese, tratamento e seguimento da doença. Frente ao aumento mundial das infecções estreptocócicas graves nos últimos 10 anos, é provável que a meningite neonatal por Streptococcus pyogenes se torne mais frequente no futuro, sendo importante estar alerta para o diagnóstico precoce e as possíveis complicações dessa infecção potencialmente letal.PALAVRAS-CHAVE: meningite bacteriana, recém-nascido, Streptococcus do grupo A, trombose venosa, seio sagital. Neonatal Streptococcus pyogenes meningitis and sagittal sinus thrombosis: case reportABSTRACT -We report a case of Streptococcus pyogenes meningitis in a 18 days year-old-girl with clinical course complicated by sagittal sinus thrombosis. Some aspects of the pathogenesis, treatment and follow-up of the disease are discussed. The world increase of serious streptococcal infections in the last 10 years, probably will become neonatal Streptococcus pyogenes meningitis more frequent in the future and it is important to be alert for the precocious diagnosis and the possible complications of that potentially lethal infection.

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Fatal Group a Streptococcal Toxic Shock-Like Syndrome in a Child With Varicella: Report of the First Well Documented Case With Detection of the Genetic Sequences That Code for Exotoxins Spe a and B, in São Paulo, Brazil

Sztajnbok

Lovgren²,

Brandileone

et al. 1999

Rev. Inst. Med. trop. S. Paulo

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A previously healthy seven-year-old boy was admitted to the intensive care unit because of toxaemia associated with varicella. He rapidly developed shock and multisystem organ failure associated with the appearance of a deep-seated soft tissue infection and, despite aggressive treatment, died on hospital day 4. An M-non-typable, spe A and spe B positive Group A Streptococcus was cultured from a deep soft tissue aspirate. The criteria for defining Streptococcal toxic shock-like syndrome were fulfilled. The authors discuss the clinical and pathophysiological aspects of this disease as well as some unusual clinical findings related to this case.

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Group A Streptococcal Meningitis and Toxic Shock-Like Syndrome in a Three-Month-Old Girl in Brazil

Cited by 3 publications

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Meningite otogênica por Streptococcus pyogenes sorotipo M3

Meningite otogênica por Streptococcus pyogenes sorotipo M3

Meningite neonatal por Streptococcus pyogenes e trombose de seio sagital: relato de caso

Fatal Group a Streptococcal Toxic Shock-Like Syndrome in a Child With Varicella: Report of the First Well Documented Case With Detection of the Genetic Sequences That Code for Exotoxins Spe a and B, in São Paulo, Brazil

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