Use of intravenous immunoglobulin therapy in the treatment of septic shock, in particular severe invasive group A streptococcal disease.

Indian Journal of Critical Care Medicine : Peer-reviewed, Official Publication of Indian Society of Critical Care Medicine
Ajay H Raithatha, Daniele C Bryden

Abstract

Group A streptococcus (GAS) is a β-hemolytic bacterium often found in the throat and skin. The two most severe clinical manifestations of GAS are streptococcal toxic shock syndrome and necrotizing fasciitis. Intravenous immunoglobulin (IVIg) is a gamma globulin made from purified pooled plasma of thousands of donors, consisting mainly of IgG. We report the case of a 40-year-old man admitted after 2 days of vomiting and severe right-sided chest pain. He was hypotensive with a sinus tachycardia, pyrexial, and vasodilated. The only other positive finding was a swollen and erythematous chest wall. Muscle layer biopsies and blood cultures soon grew extensive GAS, and an initial diagnosis of necrotizing fasciitis was made. The clinical syndrome was of severe septic shock secondary to invasive GAS. The patient quickly deteriorated with a worsening metabolic acidosis. Despite maximal intensive care therapy including fluids, vasoactive agents, and also activated protein C, the patient continued to remain profoundly hypotensive. A decision was made to commence IVIg, with the aim of immunomodulation of the inflammatory cascade seen in sepsis. Over the next 24 hours the patient improved, was extubated 3 days later, and subsequently dischar...Continue Reading

References

Jan 1, 1993·Journal of Clinical Pathology·D P Casemore, C Roberts
May 5, 2000·The Cochrane Database of Systematic Reviews·M M AlejandriaJ B Mantaring
May 29, 2000·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·R KaulD E Low
Jun 19, 2001·The Cochrane Database of Systematic Reviews·M M AlejandriaJ B Mantaring
Mar 1, 2002·The Cochrane Database of Systematic Reviews·M M AlejandriaJ B Mantaring
Jul 29, 2003·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Jessica DarenbergUNKNOWN StreptIg Study Group
Dec 27, 2005·Best Practice & Research. Clinical Haematology·R John Looney, Jennifer Huggins
Feb 7, 2007·Annals of Internal Medicine·Alexis F TurgeonPaul C Hébert
Sep 7, 2007·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Rosalyn E O'LoughlinUNKNOWN Active Bacterial Core Surveillance Team
Dec 13, 2007·Critical Care Medicine·K Georg KreymannStefan Kluge
Dec 13, 2007·Critical Care Medicine·Karl WerdanUNKNOWN Score-Based Immunoglobulin Therapy of Sepsis (SBITS) Study Group
Dec 26, 2007·Critical Care Medicine·R Phillip DellingerUNKNOWN World Federation of Societies of Intensive and Critical Care Medicine
Oct 22, 2008·BMJ : British Medical Journal·Penny Fitzharris, Miriam Hurst
May 29, 2009·Journal of Autism and Developmental Disorders·Sally Clifford, Cheryl Dissanayake
Jul 11, 2009·Clinical Reviews in Allergy & Immunology·Shaye KivityYehuda Shoenfeld
Oct 1, 2009·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Samir S ShahJames E Levin
Dec 17, 2009·Drug Safety : an International Journal of Medical Toxicology and Drug Experience·Michel Erlewyn-LajeunesseJonathan R Benger
Mar 20, 2010·Drug Resistance Updates : Reviews and Commentaries in Antimicrobial and Anticancer Chemotherapy·Fazlul H SarkarShadan Ali
May 8, 2010·Drug and Therapeutics Bulletin

❮ Previous
Next ❯

Citations

May 7, 2014·European Journal of Haematology·Shiue-Wei LaiYi-Ying Wu
Aug 25, 2016·Archivum Immunologiae Et Therapiae Experimentalis·Miroslav PruchaStefan Russwurm
May 3, 2019·American Journal of Industrial Medicine·Stephanie MyersPaul Landsbergis
Sep 13, 2017·British Journal of Hospital Medicine·Oliver SandersRajnish Saha

❮ Previous
Next ❯

Methods Mentioned

BETA
biopsies

Software Mentioned

Lidco

Related Concepts

Trending Feeds

COVID-19

Coronaviruses encompass a large family of viruses that cause the common cold as well as more serious diseases, such as the ongoing outbreak of coronavirus disease 2019 (COVID-19; formally known as 2019-nCoV). Coronaviruses can spread from animals to humans; symptoms include fever, cough, shortness of breath, and breathing difficulties; in more severe cases, infection can lead to death. This feed covers recent research on COVID-19.

Blastomycosis

Blastomycosis fungal infections spread through inhaling Blastomyces dermatitidis spores. Discover the latest research on blastomycosis fungal infections here.

Nuclear Pore Complex in ALS/FTD

Alterations in nucleocytoplasmic transport, controlled by the nuclear pore complex, may be involved in the pathomechanism underlying multiple neurodegenerative diseases including Amyotrophic Lateral Sclerosis and Frontotemporal Dementia. Here is the latest research on the nuclear pore complex in ALS and FTD.

Applications of Molecular Barcoding

The concept of molecular barcoding is that each original DNA or RNA molecule is attached to a unique sequence barcode. Sequence reads having different barcodes represent different original molecules, while sequence reads having the same barcode are results of PCR duplication from one original molecule. Discover the latest research on molecular barcoding here.

Chronic Fatigue Syndrome

Chronic fatigue syndrome is a disease characterized by unexplained disabling fatigue; the pathology of which is incompletely understood. Discover the latest research on chronic fatigue syndrome here.

Evolution of Pluripotency

Pluripotency refers to the ability of a cell to develop into three primary germ cell layers of the embryo. This feed focuses on the mechanisms that underlie the evolution of pluripotency. Here is the latest research.

Position Effect Variegation

Position Effect Variagation occurs when a gene is inactivated due to its positioning near heterochromatic regions within a chromosome. Discover the latest research on Position Effect Variagation here.

STING Receptor Agonists

Stimulator of IFN genes (STING) are a group of transmembrane proteins that are involved in the induction of type I interferon that is important in the innate immune response. The stimulation of STING has been an active area of research in the treatment of cancer and infectious diseases. Here is the latest research on STING receptor agonists.

Microbicide

Microbicides are products that can be applied to vaginal or rectal mucosal surfaces with the goal of preventing, or at least significantly reducing, the transmission of sexually transmitted infections. Here is the latest research on microbicides.