Streptococcus pyogenes toxic shock syndrome. Clinical case presentation

Abstract

Invasive Streptococcus Pyogenes disease can occur in children with a spectrum of manifestations ranging from low initial symptoms or non-specific clinical symptoms, to severe forms of high morbidity and mortality that require intensive care. Toxic Shock Syndrome by S. Pyogenes can have a very rapid evolution, with a case fatality rate of between 35 and 40%, so the early diagnosis of the infection and management in the emergency room acquires a transcendental importance. We present a clinical case of a 9-year-old patient admitted to hospital with symptoms compatible with acute gastroenteritis with dehydration that finally progressed rapidly with hemodynamic decompensation and death. From the samples extracted postmortem, a disseminated infection by S. Pyogenes; also virulence factors related to this invasive picture were detected, indicative of the course of a toxic shock syndrome. The aim of this article is to provide evaluation elements for clinical pediatric practice, in order to make visible the various forms of presentation of streptococcal infection.