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PMID: 8903167 Published · ppublish English Comparative Study Journal Article Review

Streptococcal toxic-shock syndrome: spectrum of disease, pathogenesis, and new concepts in treatment.

Emerging infectious diseases ·Vol. 1 ·No. 3 ·1995-00-00 ·Pages 69-78

Stevens DL

Abstract

Since the 1980s there has been a marked increase in the recognition and reporting of highly invasive group A streptococcal infections with or without necrotizing fasciitis associated with shock and organ failure. Such dramatic cases have been defined as streptococcal toxic-shock syndrome. Strains of group A streptococci isolated from patients with invasive disease have been predominantly M types 1 and 3 that produce pyrogenic exotoxin A or B or both. In this paper, the clinical and demographic features of streptococcal bacteremia, myositis, and necrotizing fasciitis are presented and compared to those of streptococcal toxic-shock syndrome. Current concepts in the pathogenesis of invasive streptococcal infection are also presented, with emphasis on the interaction between group A Streptococcus virulence factors and host defense mechanisms. Finally, new concepts in the treatment of streptococcal toxic-shock syndrome are discussed.

MeSH Terms
Animals Anti-Bacterial Agents/therapeutic use Bacteremia/etiology,microbiology Clindamycin/therapeutic use Clostridium/pathogenicity Clostridium perfringens/pathogenicity Debridement Drug Resistance, Microbial Endotoxins/adverse effects Exotoxins/adverse effects Fasciitis, Necrotizing/etiology,microbiology Humans Mice Myositis/etiology,microbiology Penicillin Resistance Penicillins/therapeutic use Shock, Septic/drug therapy,etiology,microbiology Streptococcal Infections/drug therapy,etiology,microbiology,therapy Streptococcus pyogenes/drug effects,metabolism,pathogenicity Virulence
Chemicals
Anti-Bacterial Agents Endotoxins Exotoxins Penicillins Clindamycin
Authors & Affiliations
1 authors, click to expand affiliations / ORCID
Stevens D L
University of Washington School of Medicine, Seattle, Washington, USA.
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Article Info
Journal
Emerging infectious diseases
Abbr.
Emerg Infect Dis
ISSN
1080-6040
DOI
10.3201/eid0103.950301
Published
1995-00-00
Pages
69-78
Language
English
Region
United States
NLM ID
9508155
PMCID
PMC2626872
Subset
IM
External Links
PubMed source DOI: 10.3201/eid0103.950301 PMC Full Text View journal details
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