Abstract
Streptococcal toxic shock-like syndrome (TSLS) is a disease with extremely poor prognosis, and can lead to shock-induced multiple organ failure. The majority of cases of TSLS are caused by the severely pathogenic group A streptococcus, while a number of studies have reported on TSLS caused by other bacteria. We report a case of TSLS due to group G streptococcus.
A 72-year-old woman had been treated with hemodialysis therapy for renal failure from chronic glomerulonephritis since 2006. She underwent pylorus-preserving pancreaticoduodenectomy in September 2013 owing to middle and inferior common bile duct cancer. Thereafter, she was admitted to our hospital because of tarry stool. Under the diagnosis of ulcer at the duodenojejunal anastomosis, we treated her with proton pump inhibitor (PPI). Her consciousness level suddenly deteriorated, and we diagnosed her as disseminated intravascular coagulation (DIC) and septic shock by blood test.
After admission to the ICU, she was treated with antibiotics and immunoglobulin, and blood purification with CHDF and hemoadsorption were started. However, she died of sepsis one day after admission to the ICU. Streptococcus dysgalactiae was detected in the blood, and Gram-positive cocci were observed around vascular access afterward.
