Recurrent invasive group A streptococcal infection with four-limb amputation in an immunocompetent child

Nour Gazzaz, Timothy Mailman, Jennifer Ruth Foster

Research output: Contribution to journalArticlepeer-review

1 Citation (Scopus)

Abstract

We report a previously well paediatric patient with two distinct presentations of invasive group A streptococcus (GAS) infection resulting in significant morbidity. The first episode, following GAS pharyngitis, involved multiorgan dysfunction syndrome. This included cardiorespiratory and acute hepatorenal failure and purpura fulminans that eventually necessitated four-limb amputation. The second episode occurred 12 months later, from undetermined aetiology, and resulted in septic shock. Molecular analysis of the emm gene and PCR for Serum Opacity Factor revealed that the initial isolate was M Type 4 and sof gene positive while the second isolate was M Type 1 and sof gene negative. Immunological investigations, including CH50, quantitative IgA, IgM and IgG, and flow cytometry measuring lymphocyte subsets, and vaccine response to measles, mumps, rubella and pneumococcus were normal. This is the first report of recurrent bacteraemia from different strains of Streptococcus pyogenes infection in an apparently immunocompetent child.

Original languageEnglish
JournalBMJ Case Reports
Volume2018
DOIs
Publication statusPublished - Jul 30 2018

Bibliographical note

Publisher Copyright:
© BMJ Publishing Group Limited 2018. No commercial re-use. See rights and permissions. Published by BMJ.

ASJC Scopus Subject Areas

  • General Medicine

PubMed: MeSH publication types

  • Case Reports
  • Journal Article

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