Abstract
A 52-year-old man with chronic granulomatous interstitial pneumonitis suffered from invasive group A streptococcal infection. His chest x-ray showed bilateral interstitial shadows in the lower lung fields since childhood. He was admitted to Keio University Hospital because of fever, productive cough, and necrosis of the distal extremity. The chest radiographic appearance worsened and he developed low blood pressure, liver dysfunction, thrombocytopenia, and lymphocytopenia. Blood culture yielded T-11 strainStreptococcus pyogenes, which generated type B and C pyrogenic exotoxins. This may be the first report to confirm T-11Streptococcus pyogenes as the causative organism for invasive group A streptococcal infection in Japan. The patient's condition improved after treatment with panipenem and subsequent combination therapy with high-dose penicillin G and gentamicin. An immunodeficiency state associated with the chronic granulomatous lung disease was strongly suspected.
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