Pharyngitis due to group C hemolytic streptococci in children

Abstract

stream or (2) altered bowel mucosa may have allowed enteric organisms to invade the bloodstream, resulting in secondary sepsis. Neither of our patients had intravenous fluid infusing at a single site for more than 48 hours. Maki and associates ~ noted that only one of 535 patients receiving intravenous fluid therapy through scalp vein needles developed septicemia. It seems improbable that our two patients developed Klebsiella sepsis secondary to scalp vein needles. There were no other concurrent cases of Klebsiella sepsis while either of the two patients was hospitalized. Alternately, shigellae may disrupt the bowel mucosa and allow the penetration of other enteric bacteria. Haltalin and Nelson :~ suggested this as the explanation for secondary Aerobacter sepsis complicating shigellosis in three of their patients. Our two patients, as did those patients of Haltalin and Nelson, had initial improvement and then developed a secondary fever. Blood cultures obtained during the secondary fever revealed septicemia. Secondary temperature elevation rarely occurs during Shigella dysentery and should serve as a marker for a possibly serious complication of Shigella dysentery or intravenous fluid therapy. Blood cultures should be obtained in the event of a secondary fever so that gramnegative sepsis might be recognized quickly and appropriately treated.