The Flesh-Eating Bacterium: What's Next?

Since the 1980s, there has been a marked increase in the recognition and reporting of highly invasive group A streptococcal (GAS) infections associated with shock and organ failure, with or without necrotizing fasciitis. Such dramatic cases have been defined as streptococcal toxic shock syndrome (St...

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Bibliographic Details
Published in:The Journal of infectious diseases 1999-03, Vol.179 (Supplement-2), p.S366-S374
Main Author: Stevens, Dennis L.
Format: Article
Language:English
Subjects:
Bacteremia
Bacteremia - etiology
Bacterial diseases
Biological and medical sciences
Epidemiology
exotoxin A
exotoxin B
Exotoxins
Fasciitis, Necrotizing - diagnosis
Fasciitis, Necrotizing - drug therapy
Fasciitis, Necrotizing - etiology
Human bacterial diseases
Humans
Infections
Infectious diseases
Medical sciences
Multiple Organ Failure - etiology
Myositis
Myositis - etiology
Necrotizing fasciitis
Penicillin
Penicillins - therapeutic use
Shock, Septic - diagnosis
Shock, Septic - drug therapy
Shock, Septic - etiology
Staphylococcal infections, streptococcal infections, pneumococcal infections
Streptococcal infections
Streptococcal Infections - diagnosis
Streptococcal Infections - drug therapy
Streptococcal Infections - etiology
Streptococcus
Streptococcus pyogenes
Streptococcus pyogenes - classification
Streptococcus pyogenes - isolation & purification
Streptococcus pyogenes - pathogenicity
toxic shock syndrome
Toxicity
Virulence
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Summary:Since the 1980s, there has been a marked increase in the recognition and reporting of highly invasive group A streptococcal (GAS) infections associated with shock and organ failure, with or without necrotizing fasciitis. Such dramatic cases have been defined as streptococcal toxic shock syndrome (StrepTSS). Strains of GAS isolated from patients with invasive disease have been predominantly M types 1 and 3, which produce either pyrogenic exotoxin A or B or both. The clinical and demographic features of streptococcal bacteremia, myositis, and necrotizing fasciitis are presented and compared with those of StrepTSS. Current concepts in the pathogenesis of invasive streptococcal infection will be presented, with emphasis on the interaction between GAS virulence factors and host defense mechanisms. Finally, new concepts in the treatment of StrepTSS will be discussed.
ISSN:0022-1899
1537-6613
DOI:10.1086/513851