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  • Title: Streptococcus pyogenes-purpura fulminans as an invasive form of group A streptococcal infection.
    Author: Okuzono S, Ishimura M, Kanno S, Sonoda M, Kaku N, Motomura Y, Nishio H, Oba U, Hanada M, Fukushi JI, Urata M, Kang D, Takada H, Ohga S.
    Journal: Ann Clin Microbiol Antimicrob; 2018 Jul 09; 17(1):31. PubMed ID: 29986727.
    Abstract:
    BACKGROUND: Streptococcus pyogenes is an uncommon pathogen of purpura fulminans, and the pathogenesis of S. pyogenes-purpura fulminans remains unclear because of paucity of cases. We reported a pediatric case of S. pyogenes-purpura fulminans with literature review of the disease. CASE PRESENTATION: A 3-year-old boy showed limping, lethargy and acral gangrene within 24 h. A diagnosis of S. pyogenes-purpura fulminans was made for bacterial isolation from throat and peripheral blood. Intensive therapy led to a survival with amputation of the left distal metatarsal bone, and normal development. The isolated M12 carried no mutation of csrS/R or rgg. Thrombophilia or immunodeficiency was excluded. DISCUSSION: Twelve-reported cases (9 pediatric and 3 elderly) of S. pyogenes-purpura fulminans started with shock and coagulopathy. Five patients age < 8 years had no underlying disease and survived. One youngest and two immunocompromised patients died. CONCLUSION: Streptococcus pyogenes-acute infectious purpura fulminans is a distinctive rare form of aggressive GAS infections.
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