Streptococcus pyogenes-purpura fulminans as an invasive form of group A streptococcal infection |
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| Authors: | Sayaka Okuzono Masataka Ishimura Shunsuke Kanno Motoshi Sonoda Noriyuki Kaku Yoshitomo Motomura Hisanori Nishio Utako Oba Masuo Hanada Jun-ichi Fukushi Michiyo Urata Dongchon Kang Hidetoshi Takada Shouichi Ohga |
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| Affiliation: | 1.Department of Pediatrics, Graduate School of Medical Sciences,Kyushu University,Fukuoka,Japan;2.Division of Pediatrics,Oita Prefectural Hospital,Oita,Japan;3.Department of Plastic Surgery,Kyushu University Hospital,Fukuoka,Japan;4.Department of Orthopaedic Surgery, Graduate School of Medical Sciences,Kyushu University,Fukuoka,Japan;5.Department of Clinical Chemistry and Laboratory Medicine,Kyushu University Hospital,Fukuoka,Japan |
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| Abstract: | BackgroundStreptococcus pyogenes is an uncommon pathogen of purpura fulminans, and the pathogenesis of S. pyogenes-purpura fulminans remains unclear because of paucity of cases. We reported a pediatric case of S. pyogenes-purpura fulminans with literature review of the disease.Case presentationA 3-year-old boy showed limping, lethargy and acral gangrene within 24 h. A diagnosis of S. pyogenes-purpura fulminans was made for bacterial isolation from throat and peripheral blood. Intensive therapy led to a survival with amputation of the left distal metatarsal bone, and normal development. The isolated M12 carried no mutation of csrS/R or rgg. Thrombophilia or immunodeficiency was excluded.DiscussionTwelve-reported cases (9 pediatric and 3 elderly) of S. pyogenes-purpura fulminans started with shock and coagulopathy. Five patients age ConclusionStreptococcus pyogenes-acute infectious purpura fulminans is a distinctive rare form of aggressive GAS infections. |
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