2016 Volume 7 Issue 1 Pages 68-71
【Background】Streptococcal toxic shock syndrome (STSS) is a severe infectious disease associated with Streptococcus pyogenes (GAS) and can cause severe septic shock and multiple organ failure emerging in just a few hours. Streptococcal pyrogenic exotoxins, which have superantigens, are known to induce the massive production of inflammatory cytokines.【Case】An 71 year-old man with fever and severe abdominal pain was suspected of having generalized peritonitis and underwent emergency surgery. Only purulent ascites were found around the duodenum. Cultures of ascites and blood were positive for S. pyogenes. Primary peritonitis due to S. pyogenes was diagnosed. Septic shock after surgery was improved immediately by Polymyxin B direct hemoperfusion (PMX-DHP) and continuous renal replacement therapy (CRRT) using AN69ST membrane hemofilter.【Conclusion】PMX-DHP and CRRT using AN69ST membrane hemofilter were considered to be an effective treatment for in patients with STSS. Further study is needed.
