B군 사슬알균에 의한 독소충격증후군: 증례보고 및 문헌고찰
Group B Streptococcal Toxic Shock-like Syndrome: A Case Report and Review of the Literature
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초록
독소충격증후군(toxic shock syndrome, TSS)은 세균의 독소에 의해 유발되는 급성, 다장기부전 열성질환으로 흔히 독소를 생성하는 황색포도알균 또는 사슬알균에 의해 발생한다. 사슬알균 TSS는 주로 A군 사슬알균에 의하며 A군 이외의 사슬알균에 의해 발생하는 것은 드물다. 저자들은 알코올성 간경화 환자에서 B군 사슬알균(Streptococcus agalactiae)에 의한 TSS 1예를 보고하고자 한다. 환자는 의식저하와 사지에 혈성 수포로 내원하였으며, 소변과 수포에서 S. agalactiae가 분리되었다. 감수성 항생제의 투여에도 불구하고 경과가 급격하게 진행되어 내원 4일만에 사망하였다. [Ann Clin Microbiol 2014;17:91-94]
Abstract
Toxic shock syndrome is an acute and febrile illness that rapidly progress to shock and multi-organ failure, and it is caused by toxin-producing strains of Staphylococcus aureus or Streptococcus species. Streptococcal toxic shock syndrome (STSS) is usually caused by group A streptococci, but non-group A STSS is rare. In this study, we describe a case of STSS caused by Streptococcus agalactiae (group B streptococci) in a patient with alcoholic liver cirrhosis. At arrival in our hospital, the patient had a decreased mental status with hemorrhagic bullae on four extremities, and he progressed to a fatal outcome within 4 days in spite of antibiotic treatment. (Ann Clin Microbiol 2014;17:91-94)
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