STREPTOCOCCAL TOXIC-SHOCK SYNDROME - SPECTRUM OF DISEASE, PATHOGENESIS, AND NEW CONCEPTS IN TREATMENT

被引:309
作者
STEVENS, DL [1 ]
机构
[1] UNIV WASHINGTON,SCH MED,SEATTLE,WA
来源
EMERGING INFECTIOUS DISEASES | 1995年 / 1卷 / 03期
关键词
D O I
10.3201/eid0103.950301
中图分类号
R392 [医学免疫学]; Q939.91 [免疫学];
学科分类号
100102 ;
摘要
Since the 1980s there has been a marked increase in the recognition and reporting of highly invasive group A streptococcal infections with or without necrotizing fasciitis associated with shock and organ failure. Such dramatic cases have been defined as streptococcal toxic-shock syndrome. Strains of group A streptococci isolated from patients with invasive disease have been predominantly M types 1 and 3 that produce pyrogenic exotoxin A or B or both. In this paper; the clinical and demographic features of streptococcal bacteremia, myositis, and necrotizing fasciitis are presented and compared to those of streptococcal toxic-shock syndrome. Current concepts in the pathogenesis of invasive streptococcal infection are also presented, with emphasis on the interaction between group A Streptococcus virulence factors and host defense mechanisms. Finally, new concepts in the treatment of streptococcal toxic-shock syndrome are discussed.
引用
收藏
页码:69 / 78
页数:10
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