Factors determining prognosis in streptococcal toxic shock-like syndrome: results of a nationwide investigation in Japan

Microbes and Infection
Tadao HasegawaMichio Ohta

Abstract

Since the first report of streptococcal toxic shock-like syndrome (TSLS) in Japan, the numbers of reported patients have been increasing. However, clinical manifestations remain somewhat unclear, and factors potentially defining prognosis remain to be identified. We conducted a retrospective nationwide postal survey of major Japanese hospitals concerning clinical manifestations of invasive streptococcal infections including necrotizing fasciitis and TSLS. We evaluated 30 patients who died and 36 survivors. The overall mortality rate was 45%. Physical and laboratory findings on admission were compared statistically between fatal cases and surviving patients. Most laboratory results from the patients who died showed greater abnormality than results from the survivors. Patients who died had significantly fewer leukocytes and platelets, although their C-reactive protein concentrations were similar to those in survivors. Creatinine was significantly higher, and temperature and blood pressure were significantly lower, in patients who died. Patients with invasive streptococcal infections should be managed aggressively when the above features are present.

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Citations

Mar 30, 2013·BMC Research Notes·Ichiro TatsunoTadao Hasegawa
Oct 29, 2010·European Journal of Pediatrics·Antonio Rodríguez-NuñezUNKNOWN ad hoc Streptococcal Toxic Shock Syndrome collaborative group of Spanish Society of Pediatric Intensive Care
Nov 17, 2015·Japanese Journal of Infectious Diseases·Masakado MatsumotoTadao Hasegawa
Jun 20, 2006·Journal of Plastic, Reconstructive & Aesthetic Surgery : JPRAS·Sadanori AkitaAkiyoshi Hirano
Sep 12, 2017·Microbiology and Immunology·Mark A StromJonathan I Silverberg
Aug 14, 2019·Microbiology and Immunology·Ichiro TatsunoTadao Hasegawa
Dec 1, 2007·Microbiology·Ichiro TatsunoTadao Hasegawa
May 18, 2020·Journal of Orthopaedic Science : Official Journal of the Japanese Orthopaedic Association·Susumu AdachiKatsushi Takeshita

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