Streptococcal toxic shock syndrome

摘要

There is an increasing incidence of serious streptococcal infections and streptococcal toxic shock syndrome. Diagnosis remains difficult, due to the relative rarity of streptococcal toxic shock syndrome and the trivial nature of the initial symptoms. Patients deteriorate rapidly and the mortality rate is high. Group A beta-haemolytic streptococci possess numerous virulence factors, both constitutional and secreted, allowing adhesion, invasion of tissue and which provide a resistance to the host's defence system. There is an identified at-risk population, which includes women in the peripartum period. It is essential to give prior consideration to any type of shock during the third trimester of pregnancy. The current treatment given to combat shock is the administration of high-dose antibiotics, either as a single therapy or in conjunction with surgical management of the infected site. Polyclonal immunoglobulin administration has been proposed, with interesting results in terms of survival rates. Research into a Group A beta-haemolytic streptococci vaccine is of significance in the reduction of mortality from streptococcal shock.