Factors determining prognosis in streptococcal toxic shock-like syndrome: results of a nationwide investigation in Japan

Since the first report of streptococcal toxic shock-like syndrome (TSLS) in Japan, the numbers of reported patients have been increasing. However, clinical manifestations remain somewhat unclear, and factors potentially defining prognosis remain to be identified. We conducted a retrospective nationw...

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Bibliographic Details
Published in:Microbes and infection 2004-10, Vol.6 (12), p.1073-1077
Main Authors: Hasegawa, Tadao, Hashikawa, Shin-nosuke, Nakamura, Tadahiro, Torii, Keizo, Ohta, Michio
Format: Article
Language:English
Subjects:
Adolescent
Adult
Age Distribution
Aged
Bacteriology
Biological and medical sciences
Child
Child, Preschool
Clinical prognosis
Fasciitis, Necrotizing - diagnosis
Fasciitis, Necrotizing - microbiology
Fasciitis, Necrotizing - mortality
Female
Fundamental and applied biological sciences. Psychology
Humans
Infant
Infant, Newborn
Japan
Male
Microbiology
Middle Aged
Miscellaneous
Prognosis
Retrospective Studies
Retrospective study
Risk Factors
Shock, Septic - diagnosis
Shock, Septic - microbiology
Shock, Septic - mortality
Streptococcal Infections - diagnosis
Streptococcal Infections - microbiology
Streptococcal Infections - mortality
Streptococcus
Streptococcus pyogenes
Syndrome
TSLS
White blood cell
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Summary:Since the first report of streptococcal toxic shock-like syndrome (TSLS) in Japan, the numbers of reported patients have been increasing. However, clinical manifestations remain somewhat unclear, and factors potentially defining prognosis remain to be identified. We conducted a retrospective nationwide postal survey of major Japanese hospitals concerning clinical manifestations of invasive streptococcal infections including necrotizing fasciitis and TSLS. We evaluated 30 patients who died and 36 survivors. The overall mortality rate was 45%. Physical and laboratory findings on admission were compared statistically between fatal cases and surviving patients. Most laboratory results from the patients who died showed greater abnormality than results from the survivors. Patients who died had significantly fewer leukocytes and platelets, although their C-reactive protein concentrations were similar to those in survivors. Creatinine was significantly higher, and temperature and blood pressure were significantly lower, in patients who died. Patients with invasive streptococcal infections should be managed aggressively when the above features are present.
ISSN:1286-4579
1769-714X
DOI:10.1016/j.micinf.2004.06.001