ABSTRACT
Abstract Background: Severe infections due to Streptococcus dysgalactiae subsp. equisimilis (SDSE) have been identified in adults and may cause toxic shock syndrome, although with a low frequency. Case report: A preschool-age female patient, who started with an upper respiratory tract infection developing a gradual deterioration in the following three days, is described. She was admitted to the hospital in severe conditions, with tachypnea, tachycardia (200/min), hypotension (blood pressure 68/40 mmHg), capillary refill of 7 s, and erythematous maculopapular rash in thorax, abdomen and lower extremities. She received intensive management with an inadequate response. Furthermore, she developed multiple organ failure and died 8 h after admission. The blood culture was positive for S. dysgalactiae subsp. equisimilis. Conclusions: SDSE is a rare pathogen in children. In Mexico, cases of SDSE have not been reported probably due to an inaccurate identification. Mexican pediatricians should be alert to this situation.
Resumen Introducción: En adultos, se han identificado infecciones graves por Streptococcus dysgalactiae subsp. equisimilis (SDSE), que pueden causar el síndrome de choque tóxico causado por SDSE, aunque es de baja frecuencia. Caso clínico: Paciente de sexo femenino en edad preescolar. Comenzó con una infección del tracto respiratorio superior, y desarrolló un deterioro gradual en los siguientes tres días. Ingresó en el hospital en condiciones graves, con taquipnea, taquicardia (200/min), hipotensión (tensión arterial, TA 68/40 mmHg), llenado capilar de 7 s y erupción maculopapular eritematosa en el tórax, abdomen y extremidades inferiores. Recibió manejo intensivo, sin una buena respuesta. Posteriormente, desarrolló datos de falla orgánica múltiple y murió 8 h después de su ingreso. El hemocultivo fue positivo para S. dysgalactiae subsp. equisimilis. Conclusiones: El SDSE es un patógeno raro en los niños. En México, no se han reportado casos de SDSE probablemente debido a una identificación errónea. Los pediatras mexicanos deben estar atentos a esta situación.
Subject(s)
Child, Preschool , Female , Humans , Shock, Septic/diagnosis , Streptococcal Infections/diagnosis , Streptococcus/isolation & purification , Shock, Septic/physiopathology , Shock, Septic/microbiology , Streptococcal Infections/physiopathology , Streptococcal Infections/microbiology , Fatal Outcome , Mexico , Multiple Organ Failure/microbiologyABSTRACT
Background & objectives: Rheumatic fever (RF)/rheumatic heart disease (RHD) caused by Group A streptococcus (GAS) are more prevalent in north India as compared to the western world, where invasive diseases are common. This could be due to variation in the virulence of GAS in different geographic locations. Hence, we studied the virulence potential of GAS isolated from the throat of children from north India. Methods: Fifty GAS isolated consecutively, from children with mild pharyngitis (20), severe pharyngitis (24) and asymptomatic pharyngeal carriers (6), were characterized by emm typing and opacity factor (OF). Adherence and internalization of GAS in HEp-2 cells and opsonophagocytosis in convalescent serum samples were studied. Results: Twenty emm types, six sequence types, and one non-typeable GAS were circulating in the community. emm type 74, 11, 68, StI129 and NS292 were most prevalent. Twenty seven (54%) GAS isolates were OF negative. Sixty five per cent of the most prevalent emm types were OF negative indicating their rheumatogenic potential. Adhesion of GAS ranged from 0.1 to 100 per cent. Forty eight per cent of GAS were highly adherent. Invasion of GAS in HEp-2 cells ranged between 0 to 30 per cent. Only 20 per cent isolates exhibited highest invasion. GAS were opsonophagocytosed with highly divergent efficiency ranging from 0 to 91.7 per cent. Nineteen GAS were not opsonophagocytosed and 15 multiplied during the assay. Isolates of the same emm type also varied in their virulence potential. Interpretation & conclusions: GAS isolates from the throat of children from north India belonged to several emm types, majority were OF negative, excellent adherents but poor invaders. This explains why throat infections in these children tend to lead to ARF/RHD rather than invasive diseases. A few isolates exhibiting high invasion efficiency indicate that GAS throat cultures can also lead to invasive diseases.
Subject(s)
Adolescent , Bacterial Typing Techniques , Child , Child, Preschool , Humans , India , Pharyngitis/microbiology , Rheumatic Fever/microbiology , Streptococcal Infections/microbiology , Streptococcal Infections/physiopathology , Streptococcus pyogenes/isolation & purification , Streptococcus pyogenes/pathogenicityABSTRACT
A pesar de los avances en el diagnóstico y en el tratamiento antibiótico y quirúrgico, la endocarditis infecciosa sigue siendo una enfermedad con una mortalidad elevada. Los estudios llevados a cabo en nuestro país y en otros países demostraron que el perfil clínico del paciente ha cambiado. Existe mayor prevalencia de pacientes añosos con enfermedad degenerativa valvular, las endocarditis protésicas y nosocomiales son más frecuentes y aumentó la presencia del Staphylococcus aureus. Estos cambios podrían justificar la ausencia de disminución en la mortalidad de esta enfermedad y plantean la necesidad de encarar enfoques más agresivos de tratamiento mediante la confección de estudios prospectivos bien diseñados y controlados.
In spite of the advance in diagnosis and antibiotic and surgical treatment, mortality of infective endocarditis remains high. Recent studies in various countries and in Argentina have shown that the clinical profile of infective endocarditis has changed. Currently the patients are older with higher frequency of degenerative valve disease and prosthetic valve and nosocomial endocarditis. The incidence of Staphylococcus aureus as etiological agent has increased. These changes may justify the absence of decrease in mortality and suggests that more aggressive measures are needed based on prospective, well designed and controlled trials.
Subject(s)
Adult , Aged , Female , Humans , Male , Middle Aged , Endocarditis, Bacterial , Staphylococcal Infections , Streptococcal Infections , Anti-Bacterial Agents/therapeutic use , Bacteremia/physiopathology , Cross Infection , Echocardiography, Doppler , Echocardiography, Transesophageal , Endocarditis, Bacterial/diagnosis , Endocarditis, Bacterial/physiopathology , Endocarditis, Bacterial/therapy , Prosthesis-Related Infections/physiopathology , Staphylococcus aureus , Staphylococcal Infections/diagnosis , Staphylococcal Infections/physiopathology , Staphylococcal Infections/therapy , Streptococcal Infections/diagnosis , Streptococcal Infections/physiopathology , Streptococcal Infections/therapy , Viridans StreptococciABSTRACT
OBJECTIVE: To assess the contribution of neonatal electroencephalogram (EEG) and its correlation with the neurological examination at age of 9 months in newborns with bacterial neonatal meningitis. METHOD: Twenty seven infants were studied with positive cerebrospinal fluid (CSF) culture for bacteria. We used the worse EEG result during acute phase of meningitis, and performed neurologic follow-up after discharge from hospital. Background cerebral activity was classified as normal or mildly, moderately, or markedly abnormal. Neurologic examination outcomes was classified normal, mild abnormalities, moderate abnormalities and severe abnormalities. RESULTS: EEG performed in the neonatal period during acute bacterial meningitis predicts adverse outcome early at age of 9 months, and had a significant correlation with cephalic perimeter and active tone alterations. CONCLUSION: Neonatal EEG is useful for predicting abnormal outcomes, especially cephalic perimeter and active tone abnormalities at 9 months of age in infants with bacterial neonatal meningitis.
OBJETIVO: Medir la contribución del electroencefalograma (EEG) neonatal y su correlación con el examen neurológico a la edad de 9 meses en recién nacidos con meningitis neonatal bacteriana. MÉTODO: Se estudió a 27 neonatos con cultivos positivos de líquido cefalorraquídeo a bacterias. Se uso el peor resultado del EEG obtenido durante el periodo agudo de la meningitis. El seguimiento neurológico se efectuó tras el egreso hospitalario. La actividad de fondo del EEG se clasificó en normal y anormal leve, moderada y severa. El examen neurológico se clasificó en normal, y anormal leve moderado y severo. RESULTADOS: El EEG realizado durante el periodo neonatal durante la fase aguda de la meningitis bacteriana predice bien un resultado adverso a la edad de 9 meses, con correlaciones significativas con el perímetro cefálico y con las alteraciones del tono activo. CONCLUSION: El EEG neonatal es útil para predecir anormalidades del neurodesarrollo especialmente en el perímetro cefálico y anormalidades del tono durante el primer año de vida en niños que tuvieron meningitis neonatal bacteriana.
Subject(s)
Adolescent , Adult , Female , Humans , Infant , Infant, Newborn , Male , Brain/pathology , Electroencephalography , Infant, Premature, Diseases/physiopathology , Meningitis, Bacterial/physiopathology , Staphylococcal Infections/physiopathology , Streptococcal Infections/physiopathology , Acute Disease , Apgar Score , Evoked Potentials , Follow-Up Studies , Infant, Premature , Meningitis, Bacterial/cerebrospinal fluid , Neurologic Examination , Staphylococcal Infections/cerebrospinal fluid , Streptococcal Infections/cerebrospinal fluidABSTRACT
As doenças das vias aéreas superiores fazem parte da rotina diária dos ambulatórios de Clínica Médica. O presente artigo destaca as doenças da orofaringe, em especial o sintoma de dor de garganta. Enfatiza os principais agentes etiológicos, por exemplo, vírus, bactérias ou fungos. Descreve o diagnóstico clínico, os exames complementares e a terapêutica específica para cada caso.
Subject(s)
Male , Female , Streptococcal Infections/etiology , Streptococcal Infections/physiopathology , Respiratory Tract Infections/diagnosis , Respiratory Tract Infections/etiology , Respiratory Tract Infections/physiopathology , Azithromycin/therapeutic use , Haemophilus/pathogenicity , Mycoplasma/pathogenicity , Streptococcus agalactiae/pathogenicityABSTRACT
Group C streptococci are a common cause of infection in animals and a rare cause of bacteremia in human beings. The entity is often seen in elderly people with a severe underlying illness. We report here the only case of Group C streptococcal bacteremia reported in our hospital, caused by Streptococcus equisimilis, a beta-hemolytic Group C streptococcus. The patient was a 10-year old male with a known history of aplastic anemia. In spite of specific therapy with penicillin, the outcome was fatal.
Subject(s)
Child , Fatal Outcome , Humans , India , Male , Streptococcal Infections/physiopathology , Streptococcus equi/isolation & purificationABSTRACT
This paper describes the devastating outcome of a neonate who presented with severe late onset group B beta-haemolytic streptococcal (GBS) disease. There were extensive infarcts of the brain and gangrene of the toes. The purpose of this report is to alert healthcare workers of the unusual presentation and that fatal late onset group B beta-haemolytic streptococcal disease may occur despite early and effective management
Subject(s)
Humans , Male , Infant, Newborn , Streptococcal Infections/diagnosis , Sepsis/diagnosis , Streptococcus agalactiae/isolation & purification , Cellulite/microbiology , Cellulite/pathology , Toes/pathology , Fatal Outcome , Gangrene/diagnosis , Gangrene/microbiology , Gangrene/pathology , Streptococcal Infections/physiopathology , Meningitis, Bacterial/diagnosis , Sepsis/microbiology , Sepsis/pathology , Streptococcus agalactiae/pathogenicitySubject(s)
Humans , Infant , Child, Preschool , Child , Adolescent , Asthma , Hypersensitivity, Immediate , Streptococcal Infections/physiopathology , Pharyngitis , Rhinitis, Allergic, Perennial/microbiology , Streptococcus pyogenes , Acute Disease , Asthma , Th1 Cells/immunology , /immunology , Streptococcal Infections/complications , Streptococcal Infections/epidemiology , Pharyngitis , Respiratory Tract Infections , Rhinitis, Allergic, Perennial/complicationsABSTRACT
Se presentan tres situaciones clínicas pediátricas que fueron originadas por estreptococos del grupos A, con manifestaciones típicas y atípicas. La relación de esta bacteria con la teoría de los superantígenos puede ser evidente. Los pacientes fueron detallados bajo observación clínica permanente, evaluados y manejados por un grupo interdisciplinario hasta su egreso sin defunciones. Se hace una breve revisión del concepto de superantígenos en pediátria.
Subject(s)
Humans , Streptococcal Infections/diagnosis , Streptococcal Infections/physiopathology , Superantigens/physiology , Superantigens/immunologySubject(s)
Humans , Male , Female , Infant, Newborn , Infant , Child, Preschool , Adolescent , Respiratory Insufficiency/etiology , Respiratory Insufficiency/therapy , Respiratory Tract Infections/complications , Respiratory Tract Infections/diagnosis , Respiratory Tract Infections/etiology , Acute Disease/therapy , Streptococcal Infections/complications , Streptococcal Infections/physiopathology , Pneumonia/physiopathology , Respiratory Tract Infections/microbiology , Respiratory Tract Infections/prevention & control , Respiratory Tract Infections/drug therapy , Causality , Signs and SymptomsABSTRACT
Trabajo retrospectivo de revisión de 40 Historias Clínicas con diagnóstico de Uretritis, cuyo exámen bacteriológico identificó Neisseria Gonorrhoae en 76,3, otras bacterias como Estafilococos Albus, Estreptococo en 23,7. En 55,3 fueron tratados con PenicilinaProcáinica en dósis de 4,8 U.I. con resultados óptimops, el segundo antibiótico utilizado en 10,5, también con buenos resultados fué la tetraciclina en dósis de 2 gr/d. por siete días, en 10,5 se utilizaron otros antibióticos como ser Eritromicina, Gentamicina. El Estudio de contactos, y localización de los mismos no se efectuo en ninguno de los casos.
Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Urethritis/etiology , Urethritis/physiopathology , Urethritis/epidemiology , Gentamicins/administration & dosage , Gentamicins/therapeutic use , Clinical Laboratory Techniques , Exudates and Transudates/physiology , Clinical Diagnosis , Streptococcal Infections/complications , Streptococcal Infections/physiopathology , Streptococcal Infections/drug therapy , Streptococcal Infections/therapy , Penicillin G Procaine/therapeutic use , Medical Records/classification , Medical Records/statistics & numerical dataABSTRACT
Se presentan 4 casos de síndrome de shock tóxico asociados a infección por Streptococcus beta-hemolítico grupo A (Streptococcus pyogenes). Todos presentaron hipotensión y disfunción orgánica. Un caso se presentó en forma típica con fascitis necrotizante. Otro paciente tuvo una forma eritrodérmica con posterior descamación asociado a faringitis no invasiva. Una sepsis puerperal con neumonía cavitada y empiema; y un niño con faringitis y bacteremia. Se discute clínica, teorías fisiopatológicas, epidemiología y tratamiento
Subject(s)
Humans , Male , Female , Child, Preschool , Adolescent , Adult , Middle Aged , Streptococcal Infections/diagnosis , Streptococcus pyogenes/drug effects , Clindamycin/therapeutic use , Fasciitis, Necrotizing/diagnosis , Fasciitis, Necrotizing/etiology , Streptococcal Infections/physiopathology , Streptococcal Infections/drug therapy , Lactams/therapeutic use , Myositis/drug therapy , Myositis/etiology , Shock, Septic/etiology , Streptococcus pyogenes/pathogenicityABSTRACT
La glomerulonefritis aguda es una entidad clínica de comienzo agudo cuyas características son: edema, hematura (macro o microscópica) proteinuria, hipertensión arterial y oliguria. Generalmente es de origen infeccioso, siendo lo más frecuente la infección por estreptococo grupo A-B hemolítico. Ello ha significado que el término glomerulonefritis aguda implique habitualmente glomerulonefritis aguda post estreptococica (GNAPS)
Subject(s)
Glomerulonephritis/etiology , Streptococcal Infections/complications , Blood Proteins/metabolism , Complement System Proteins/metabolism , Streptococcal Infections/physiopathology , Prognosis , Streptococcus pyogenes/pathogenicitySubject(s)
Humans , Child, Preschool , Child , Infant , Pharyngitis/complications , Tonsillitis/complications , Clinical Laboratory Techniques , Colony Count, Microbial , Disease Transmission, Infectious , Drug Hypersensitivity , Glomerulonephritis , Streptococcal Infections/physiopathology , Penicillins/administration & dosage , Penicillins/adverse effects , Pharyngitis/diagnosis , Pharyngitis/drug therapy , Pharyngitis/microbiology , Rheumatic FeverSubject(s)
Humans , Streptococcal Infections/physiopathology , Streptococcus agalactiae/pathogenicity , Streptococcus pyogenes/isolation & purification , Diagnosis, Differential , Streptococcal Infections/microbiology , Pharyngitis/etiology , Pharyngitis/microbiology , Streptococcus pyogenes/pathogenicity , Tonsillitis/etiology , Tonsillitis/microbiologySubject(s)
Infant, Newborn , Infant , Child, Preschool , Child , Adolescent , Humans , Male , Female , Shock, Septic , Shock, Septic/diagnosis , Shock, Septic/epidemiology , Shock, Septic/physiopathology , Staphylococcal Infections/diagnosis , Staphylococcal Infections/epidemiology , Staphylococcal Infections/physiopathology , Streptococcal Infections/diagnosis , Streptococcal Infections/epidemiology , Streptococcal Infections/physiopathology , Signs and SymptomsABSTRACT
A frequência de portadores de estreptococos beta-hemolítico do grupo A foi estudada em 204 escolares, com idade entre 07 e 12 anos, da Escola Estadual "Dom José Gaspar", Belo Horizonte, Minas Gerais, Brasil, durante o mês de março de 1989. As amostras foram coletadas da orofaringe e para a identificaçäo dos diferentes grupos de estreptococos foi empregado o plantio em ágar-sangue, provas clássicas de bioquímica e sensibilidade a antibióticos. Observou-se que 58 escolares eram portadores de estreptococos beta-hemolíticos, sendo 26 classificados como grupo A, 24 como grupo B e 08 de outros grupos. A frequência encontrada de portadores de estreptococos beta-hemolítico do grupo A está condizente com os dados observados na literatura e sugere que o tratamento apropriado é importante para impedir sequelas causadas por este microorganismo.