Life-threatening complications of streptococcal sepsis: a PICU contemporary series

J Anesth Analg Crit Care. 2021 Dec 14;1(1):24. doi: 10.1186/s44158-021-00028-1.

Abstract

Background: Life-threatening streptococcal sepsis nowadays represents an uncommon event in previously healthy infants and children. Critically ill patients suffering from severe streptococcal sepsis complications may present with pre-antibiotic era clinical pictures and require a timely clinical approach to achieve restitutio ad integrum.

Results: We report a series of four patient groups affected by an uncommon life-threatening streptococcal sepsis, each of them exhibiting some distinct features. Streptococcus Agalactiae sepsis was associated with cerebral thrombotic/ischaemic lesions, whereas severe cardiogenic shock was prominent in the Streptococcus Viridans group; Streptococcus Faecalis and β-hemolytic group A Streptococcus patients mostly reported lung complications.

Conclusions: Previous antibiotic treatments should not delay aggressive treatment in the intensive care setting. Early diagnostic suspicion, as well as appropriate and aggressive treatment provided within an intensive care setting are crucial for the clinical outcome.

Keywords: Intensive care; Mechanical ventilation; Septic shock; Streptococcal sepsis complications; Tissue tropism phenotypes.