A Fatal Case of Streptococcal Toxic Shock Syndrome due to Streptococcus dysgalactiae subsp. equisimilis Possibly Caused by an Intramuscular Injection

Hideharu Hagiya; Shunji Okita; Yasutoshi Kuroe; Hiroyoshi Nojima; Shinkichi Otani; Junichi Sugiyama; Hiromichi Naito; Susumu Kawanishi; Shingo Hagioka; Naoki Morimoto

doi:10.2169/internalmedicine.52.8846

CASE REPORTS

A Fatal Case of Streptococcal Toxic Shock Syndrome due to Streptococcus dysgalactiae subsp. equisimilis Possibly Caused by an Intramuscular Injection

Hideharu Hagiya, Shunji Okita, Yasutoshi Kuroe, Hiroyoshi Nojima, Shinkichi Otani, Junichi Sugiyama, Hiromichi Naito, Susumu Kawanishi, Shingo Hagioka, Naoki Morimoto

Author information

Hideharu Hagiya
Emergency Unit and Critical Care Center, Tsuyama Central Hospital, Japan
Shunji Okita
Emergency Unit and Critical Care Center, Tsuyama Central Hospital, Japan
Yasutoshi Kuroe
Emergency Unit and Critical Care Center, Tsuyama Central Hospital, Japan
Hiroyoshi Nojima
Emergency Unit and Critical Care Center, Tsuyama Central Hospital, Japan
Shinkichi Otani
Emergency Unit and Critical Care Center, Tsuyama Central Hospital, Japan
Junichi Sugiyama
Emergency Unit and Critical Care Center, Tsuyama Central Hospital, Japan
Hiromichi Naito
Emergency Unit and Critical Care Center, Tsuyama Central Hospital, Japan
Susumu Kawanishi
Emergency Unit and Critical Care Center, Tsuyama Central Hospital, Japan
Shingo Hagioka
Emergency Unit and Critical Care Center, Tsuyama Central Hospital, Japan
Naoki Morimoto
Emergency Unit and Critical Care Center, Tsuyama Central Hospital, Japan

Keywords: streptococcal toxic shock syndrome (STSS), streptococcus dysgalactiae subsp, equisimilis, group G streptococcus (GGS), intramuscular injection, sepsis

JOURNAL OPEN ACCESS

2013 Volume 52 Issue 3 Pages 397-402

DOI https://doi.org/10.2169/internalmedicine.52.8846

Details

Abstract

An 88-year-old man died of streptococcal toxic shock syndrome due to a group G streptococcus infection that was possibly caused by an intramuscular injection given 30 hours earlier in his right deltoid muscle. The causative pathogen was later identified to be Streptococcus dysgalactiae subsp. equisimilis (stG485). Although providing intramuscular injections is an essential skill of health care workers that is performed daily worldwide, it may constitute a port of entry for pathogens via skin breaches that can cause life-threatening infections. All invasive procedures should be carefully performed, especially when immunologically compromised patients are involved.

Corresponding author

Register with J-STAGE for free!