Mehmet DOĞAN, Sedef TUNAOĞLU, Berna CANTER, Murat ELLİ, Cağlar CİTAK

Invasive group a beta-hemolytic streptococcal infection in children in the 2000'S: a case report

A grubu beta hemolitik streptokoklar (GABHS) invaziv ya da invaziv olmayan ve nonsüpüratif hastalıklara neden olabilirler. Son yıllarda, erken antibiyotik tedavilerine rağmen ölümcül olabilen invazif GABHS enfeksiyonlarının sağlıklı çocuklarda giderek daha sık karşılaşıldığını gösteren yayınlar artmaktadır. Biz burada ölümle sonuçlanan ilerleyici nekrotizan pnomoni ve sepsisli bir olguyu sunduk. Otopsi ile nekrotizan pnomoni gösterildi ve organ sürüntü kültürlerinden GABHS izole edildi. Bu olgu invaziv GABHS enfeksiyonun 21. yüzyılda sağlıklı çocuklar için tehlike olduğunu ve hızla ilerleyici nekrotizan pnomonilerde GABHS araştırılması gerektiğini göstermektedir.

2000'li yıllarda çocukluklarda invaziv a grubu beta hemolitik streptokok infeksiyonu: olgu sunumu

Group A beta hemolytic streptococcus (GABHS) causes invasive, non-invasive, and non-suppurative diseases. Reports on the increased incidence of invasive GABHS infections have shown that the majority of these infections occurred in otherwise healthy children, and may be fatal despite early administration of antibiotic treatment. We present a case where rapidly progressive necrotizing pneumonia resulted in sepsis and death. GABHS was isolated from tissue cultures taken from various organs. Necrotizing pneumonia was diagnosed at autopsy. This case indicates that invasive GABHS infections may still be a burden for the healthy children in the 21st century and GABHS must be investigated in children with rapidly progressive pneumonia.

PDF

___

1. Stevens DL, Tanner MH, Winship J, et al. Severe group A streptococcal infections associated with a toxic shock-like syndrome and scarlet fever toxin A. N Engl J Med 1989; 321: 1-7.
2. Belani K, Schlievert PM, Kaplan EL, Ferrieri P. Association of exotoxin producing group A streptococcus and severe disease in children. Pediatr Infect Dis J 1991; 10: 351-354.
3. Steer AC, Danchin MH, Carapetis JR. Group A streptococcal infections in children. Journal of Paediatrics and Child Health 2007;43:203–213
4. Carapetis JR, Steer AC, Mulholland EK, Weber M. The global burden of group A streptococcal diseases. Lancet Infect. Dis. 2005; 5: 685-94.
5. Gerber MA, Shulman ST. Rapid diagnosis of pharyngitis caused by group A streptococcci. Clin Micro Rev. 2004; 17: 571-580.
6. Hoge CW, Schwartz B, Talkington DF, Breiman RF, MacNeill EM, Englender SJ. The changing epidemiology of invasive group A streptococcal infections and the emergence of streptococcal toxic shocklike syndrome: a retrospective population-based study. JAMA. 1993; 269: 384-389.
7. Davies HD, McGeer A, Schwartz B et al. Invasive group A streptococcal infections in Ontario, Canada. N Engl J Med. 1996; 335:547-554.
8. O’Brien KL, Beall B, Barrett NL et al. Epidemiology of invasive group A streptococcus disease in the United States, 1995-1999. Clin Infect Dis 2002; 35: 268-276.
9. Carapetis JR, Robins-Browne R, Martin D et al. Increasing severity of invasive group A streptococcal disease in Australia: clinical and molecular epidemiological features and identification of a new virulent M-non-typeable clone. Clin Infect Dis 1995; 21: 1220-1227.
10. Weir E, Main C. Invasive group A streptococcal infections. CMAJ. 2006;175:32
11. Kaplan EL. Recent epidemiology of Group A streptococcal in North America and abroad: an overview. Pediatrics. 1996; 97: 945-948.
12. Siedler A, Reinert RR, Toschke M, Al-Lahham A. Regional differences in the epidemiology of invasive pneumococcal disease in toddlers in Germany. The Pediatric Infectious Disease Journal. 2005: 24; 1114-1115.
13. Vlaminckx BJM, Mascini EM, Schellekens J et al. Site-specific manifestation of invasive group A streptococcal disease: type distribution and corresponding patterns of virulence determinants. J Clin Microbiol 2003; 41: 4941-4949.
14. Chatellier S, Ihendyane N, Kansal RG. Genetic relatedness and superantigen expression in group A streptococcus serotype M1 isolates from patients with severe and non-severe invasive diseases. Infect Immun 2000; 68: 3523-3534.
15. Montgomery VL, Bratcher D. Complications associated with severe invasive streptococcal syndrome. J Pediatr 1996; 129: 602-604.
16. Cengiz AB, Kanra G, Caglar M, Kara A, Gucer S, Ince T. Fatal necrotizing pneumonia caused by group A streptococcus. J Paediatr Child Health 2005; 40: 69-71
17. Committee on Infectious Diseases. Severe Invasive Group A Streptococcal Infections: A Subject Review. Pediatrıcs 1998: 101; 136-140.
18. Gerber MA. Diagnosis and treatment of pharyngitis in children. Pediatr Clin N Am. 2005; 52: 729-747.
19. Mirza A, Wludyka P, Chiu TT, Rathore MH. Throat culture is necessary after negative rapid antigen detection tests. Clin Pediatr (Phila) 2007; 46; 241-47.
20. Brook I, Dohar JE. Management of group A beta-hemolytic streptococcal pharyngotonsillitis in children. J Fam Pract. 2006; 55: S1-11;quiz S12.
21. Kikuta H, Shibata M, Nakata S, Yamanaka T, Sakata H, et al. Efficacy of Antibiotic Prophylaxis for Intrafamilial Transmission of Group A _-Hemolytic Streptococci. Pediatr Infect Dis J 2007; 26: 139-141.