Elsevier

Microbes and Infection

Volume 6, Issue 12, October 2004, Pages 1073-1077
Microbes and Infection

Original article
Factors determining prognosis in streptococcal toxic shock-like syndrome: results of a nationwide investigation in Japan

https://doi.org/10.1016/j.micinf.2004.06.001Get rights and content
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Abstract

Since the first report of streptococcal toxic shock-like syndrome (TSLS) in Japan, the numbers of reported patients have been increasing. However, clinical manifestations remain somewhat unclear, and factors potentially defining prognosis remain to be identified. We conducted a retrospective nationwide postal survey of major Japanese hospitals concerning clinical manifestations of invasive streptococcal infections including necrotizing fasciitis and TSLS. We evaluated 30 patients who died and 36 survivors. The overall mortality rate was 45%. Physical and laboratory findings on admission were compared statistically between fatal cases and surviving patients. Most laboratory results from the patients who died showed greater abnormality than results from the survivors. Patients who died had significantly fewer leukocytes and platelets, although their C-reactive protein concentrations were similar to those in survivors. Creatinine was significantly higher, and temperature and blood pressure were significantly lower, in patients who died. Patients with invasive streptococcal infections should be managed aggressively when the above features are present.

Keywords

Streptococcus pyogenes
TSLS
Retrospective study
Clinical prognosis
White blood cell

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