Streptococcal toxic shock syndrome

摘要

A 46-year-old window cleaner was admitted acutely unwell for 48 hours with fever, myalgia, vomiting, diarrhoea, pain and swelling of his right upper arm.The patient had been in excellent health until approximately 2 months prior to admission when he started becoming increasingly tired. He had noticed what he thought were "insect bites" on his arms, legs and beard area, which were initially papular, but gradually developed into pustules. These "insect bites" had appeared after going swimming in a lake during the summer, where he would also sleep out in the grass in an area infested with rats. The household included a healthy pet dog, which had not injured him. There was no history of foreign travel. He had a 20-packs-a-year history of smoking and had drunk about 5 pints of lager a day for many years with no known liver disease. He did not use any illicit drugs and he had no significant exposure to persons with infection.