Streptococcus pyogenes-purpura fulminans as an invasive form of group A streptococcal infection

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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Abstract

Background: Streptococcus 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 presentation: A 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. Discussion: Twelve-reported cases (9 pediatric and 3 elderly) of S. pyogenes-purpura fulminans started with shock and coagulopathy. Five patients age < 8 years had no underlying disease and survived. One youngest and two immunocompromised patients died. Conclusion:Streptococcus pyogenes-acute infectious purpura fulminans is a distinctive rare form of aggressive GAS infections.

Original languageEnglish
Article number31
JournalAnnals of Clinical Microbiology and Antimicrobials
Volume17
Issue number1
DOIs
Publication statusPublished - Jul 9 2018

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Purpura Fulminans
Streptococcal Infections
Streptococcus pyogenes
Pediatrics
Lethargy
Metatarsal Bones
Gangrene
Thrombophilia
Bone Development
Immunocompromised Host
Pharynx
Amputation
Shock
Extremities
Mutation
Survival
Infection

All Science Journal Classification (ASJC) codes

  • Microbiology (medical)
  • Infectious Diseases

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Streptococcus pyogenes-purpura fulminans as an invasive form of group A streptococcal infection. / Okuzono, Sayaka; Ishimura, Masataka; Kanno, Shunsuke; Sonoda, Motoshi; Kaku, Noriyuki; Motomura, Yoshitomo; Nishio, Hisanori; Oba, Utako; Hanada, Masuo; Fukushi, Jun ichi; Urata, Michiyo; Kang, Dongchon; Takada, Hidetoshi; Ohga, Shouichi.

In: Annals of Clinical Microbiology and Antimicrobials, Vol. 17, No. 1, 31, 09.07.2018.

Research output: Contribution to journalArticle

Okuzono, Sayaka ; Ishimura, Masataka ; Kanno, Shunsuke ; Sonoda, Motoshi ; Kaku, Noriyuki ; Motomura, Yoshitomo ; Nishio, Hisanori ; Oba, Utako ; Hanada, Masuo ; Fukushi, Jun ichi ; Urata, Michiyo ; Kang, Dongchon ; Takada, Hidetoshi ; Ohga, Shouichi. / Streptococcus pyogenes-purpura fulminans as an invasive form of group A streptococcal infection. In: Annals of Clinical Microbiology and Antimicrobials. 2018 ; Vol. 17, No. 1.
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