Abstract
Background Streptococcal toxic shock-like syndrome (TSLS) is a severe infection caused by group A hemolytic streptococcus. It is clinically characterized by rapidly progressive septic shock and multiple organ failure within just a few hours. TSLS presenting as primary peritonitis is rare, especially in a male. Herein, we report a case of TSLS in a male presenting with primary peritonitis, with a review of 25 cases in Japan. Case Presentation A 51-year-old male was referred to our hospital with abdominal pain and hypotension. We made a preoperative diagnosis of peritonitis with septic shock and performed an emergency operation. Intraoperative findings indicated no marked origin of the peritonitis. Preoperative blood culture showed the presence of group A hemolytic streptococcus. The patient required intensive care involving artificial respiration, abdominal drainage and cytokine absorption therapy, and was discharged on postoperative day 25. Conclusion TSLS in a male presenting as primary peritonitis is rare. Although this condition is a severe infection, it can be treated by multimodal therapy.
Highlights
Streptococcal toxic shock-like syndrome (TSLS), called streptococcal toxic shock syndrome (STSS), was first reported in the mid-1980’s [1] and was first described in Japan by Shimizu in 1992 [2]
Primary peritonitis is a rare form of peritonitis that results from infectious organisms transmitted through the blood or lymph
Of the 25 primary peritonitis patients with group A hemolytic streptococcus, 16 (64%) developed TSLS, which suggests that this condition causes septic shock or multiple organ failure at a high rate
Summary
Streptococcal toxic shock-like syndrome (TSLS) is a severe infection caused by group A hemolytic streptococcus. It is clinically characterized by rapidly progressive septic shock and multiple organ failure within just a few hours. TSLS presenting as primary peritonitis is rare, especially in a male. We report a case of TSLS in a male presenting with primary peritonitis, with a review of 25 cases in Japan. Preoperative blood culture showed the presence of group A hemolytic streptococcus. TSLS in a male presenting as primary peritonitis is rare. This condition is a severe infection, it can be treated by multimodal therapy
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