Streptococcal Wound Infection with Evidence of Widespread Tissue Involvement

Abstract

A 5-year-old boy is presented who, in association with a severe streptococcal wound infection, developed evidence of widespread tissue insult. Symptoms included prolonged delirium, confusion, and gastrointestinal dysfunction. Biochemical abnormalities included elevated BUN, LDH, SGOT, CPK, and amylase. Urinary sediment was found to be markedly abnormal. Symptoms and laboratory measurements improved slowly on therapy. Reports of clinical material with some common features are reviewed as well as autopsy findings in fatal streptococcal infections. Also mentioned is a summary of the biochemical and pathologic effects of streptococcal exotoxins in animals. It is hypothesized that streptococcal extracellular products may be responsible for many of the symptoms and biochemical alterations occurring with streptococcal infections.