Streptogenic toxin shock syndrome A48.3

Willoughby 1986

Occurs in children and adults. In children, STSS cases can occur in conjunction with varicella that predispose to cutaneous streptococcal infections.

In 80% of cases, begins as a local streptococcal infection of the skin with very painful diffuse redness and swelling and a regional lymphadenopathy(erysipelas or necrotizing fasciitis). Non-specific general symptoms such as general feeling of illness with high temperatures, vomiting and diarrhoea, myalgia and arthralgia. Development of a fluctuating phlegmonous inflammation; danger of the development of necrotising fasciitis.

Common concomitant symptom: scarlatiniform exanthema; also formation of haemorrhagic blisters. Within a few hours hypotension with renal failure and respiratory distress syndrome.

1. Chikkamuniyappa S (2004) Streptococcal toxic shock syndrome and sepsis manifesting in a patient with chronic rheumatoid arthritis. Dermatol Online J 10: 7
2. Hashikawa S et al (2004) Characterization of group C and G streptococcal strains that cause streptococcal toxic shock syndrome. J Clin Microbiol 42: 186-192
3. Patel RA et al (2004) Reduction in pediatric hospitalizations for varicella-related invasive group A streptococcal infections in the varicella vaccine era. J Pediatr 144: 68-74
4. Zerr DM et al (1999) A case-control study of necrotizing fasciitis during primary varicella. Pediatrics 103: 783-790