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Review
, 1 (3), 69-78

Streptococcal Toxic-Shock Syndrome: Spectrum of Disease, Pathogenesis, and New Concepts in Treatment

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Review

Streptococcal Toxic-Shock Syndrome: Spectrum of Disease, Pathogenesis, and New Concepts in Treatment

D L Stevens. Emerg Infect Dis.

Abstract

Since the 1980s there has been a marked increase in the recognition and reporting of highly invasive group A streptococcal infections with or without necrotizing fasciitis associated with shock and organ failure. Such dramatic cases have been defined as streptococcal toxic-shock syndrome. Strains of group A streptococci isolated from patients with invasive disease have been predominantly M types 1 and 3 that produce pyrogenic exotoxin A or B or both. In this paper, the clinical and demographic features of streptococcal bacteremia, myositis, and necrotizing fasciitis are presented and compared to those of streptococcal toxic-shock syndrome. Current concepts in the pathogenesis of invasive streptococcal infection are also presented, with emphasis on the interaction between group A Streptococcus virulence factors and host defense mechanisms. Finally, new concepts in the treatment of streptococcal toxic-shock syndrome are discussed.

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References

    1. Clin Orthop Relat Res. 1987 Feb;(215):206-11 - PubMed
    1. Antimicrob Agents Chemother. 1987 Feb;31(2):213-8 - PubMed
    1. J Infect Dis. 1992 Aug;166(2):374-82 - PubMed
    1. Proc Natl Acad Sci U S A. 1993 Aug 15;90(16):7676-80 - PubMed
    1. Rev Infect Dis. 1991 Jan-Feb;13(1):8-11 - PubMed

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