Document Detail

Group B streptococcus toxic shock-like syndrome in a healthy woman: a case report.
MedLine Citation:
PMID:  17506375     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Toxic shock syndrome (TSS) is caused by Staphylococcus aureus infection. The disease entity manifests clinically as fever, hypotension, diffuse macular erythema that progresses to desquamation, and dysfunction of > 3 organ systems. Toxic shock-like syndrome (TSLS) has the same clinical manifestation as TSS but is caused by Streptococcus, usually group A, C or G. Here we report on a healthy woman who experienced group B Streptococcus (GBS)-related TSLS, possibly related to tampon use. CASE: A 37-year-old woman, gravida 1, para 1, met the diagnostic criteria for TSS/TSLS 5 days after her last tampon use. Blood, urine and vaginal cultures were positive only for GBS. Analysis of the blood isolate suggested a novel GBS superantigen. CONCLUSION: This is the second reported case of GBS causing tampon-associated TSS/TSLS. Up to 40% of healthy menstruating women are vaginally colonized with GBS. Superantigens elaborated by staphylococci and streptococci induce an immunologic mediator storm that affects the circulatory and end-organ systems to produce the clinical picture. Prompt medical therapy involves large-volume isotonic fluid resuscitation and antibiotic coverage with vancomycin and an antistaphylococcal beta-lactam. Clindamycin may dampen the immunologic response and endotoxin production. Corticosteroids and intravenous immunoglobulin may be useful adjuncts; however, nonsteroidal antiinflammatories should be avoided.
J Sean Begley; Robert C Barnes
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  The Journal of reproductive medicine     Volume:  52     ISSN:  0024-7758     ISO Abbreviation:  J Reprod Med     Publication Date:  2007 Apr 
Date Detail:
Created Date:  2007-05-17     Completed Date:  2007-06-25     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0173343     Medline TA:  J Reprod Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  323-5     Citation Subset:  IM    
Department of Gynecology and Gynecologic Oncology, Virginia Mason Medical Center, Seattle, Washington 98101, USA.
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MeSH Terms
Exotoxins / biosynthesis*
Menstrual Hygiene Products / adverse effects*
Shock, Septic / etiology*
Streptococcal Infections / complications*,  diagnosis,  etiology
Streptococcus agalactiae / immunology*,  isolation & purification
Superantigens / blood
Reg. No./Substance:
0/Exotoxins; 0/Superantigens

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