1/268. Group G streptococcal endocarditis.The group G streptococcus may be a more common human pathogen than previously recognized. A case of group G streptococcal endocarditis is reported and the 11 cases reported previously are reviewed. Group G endocarditis may have significant clinical and prognostic differences from endocarditis caused by the more commonly identified viridans or group D streptococci. Routine serologic grouping of beta-hemolytic streptococcal isolates from serious infections is warranted.- - - - - - - - - - ranking = 1keywords = hemolytic (Clic here for more details about this article) |
2/268. Febrile perianal streptococcal dermatitis.We describe a child with an unusual presentation of perianal streptococcal dermatitis which included fever, acral scarletiniform desquamation, and extension of erythema to involve the genitalia and proximal thighs, as well as the commonly seen well-defined erythema of the perianal area. We suggest that isolated group A beta-hemolytic streptococci (GAS) in our patient produced a pyrogenic exotoxin similar to that which appears in scarlet fever.- - - - - - - - - - ranking = 1keywords = hemolytic (Clic here for more details about this article) |
3/268. Fatal maternal beta-hemolytic group B streptococcal meningitis: a case report.meningitis secondary to beta-hemolytic group B streptococcus is rare and represents less than 1% of cases of adult meningitis. We report the first known case of maternal mortality attributed to beta-hemolytic group B streptococcal meningitis. A 23-year-old African-American woman with a benign prenatal course delivered a viable male infant at term. Labor was complicated by thick meconium for which a saline amnioinfusion was utilized. On postpartum Day 1, the patient complained of right hip pain and a headache. Within 12 hr the patient was comatose with fixed and dilated pupils. life support measures were discontinued secondary to absence of electrocortical activity. Postmortem examination revealed endomyometritis and fulminant meningitis with gram-positive cocci. Placental histologic sections demonstrated acute chorioamnionitis and bateriological cultures noted beta-hemolytic group B streptococcus. The virulence of beta-hemolytic group B streptococcus in the neonate is well recognized. This case demonstrates that beta-hemolytic group B streptococcus is also a potentially fatal maternal pathogen.- - - - - - - - - - ranking = 9keywords = hemolytic (Clic here for more details about this article) |
4/268. Non-group D streptococcal meningitis misidentified as enterococcal meningitis. Diagnostic and therapeutic implications of misdiagnosis by screening microbiology.Two patients had nonhemolytic Gram-positive coccal meningitis. Both pathogens were initially misidentified as a group D enterococcus by growth in "selective" media, which led to the use of inappropriate and potentially toxic systemic and intrathecal aminoglycosides. Careful evaluation of the antibiotic sensitivity data and additional microbiological studies allowed correct identification of the organism. The important diagnostic and therapeutic considerations in differentiating true enterococcal infections, especially meningitis, from those caused by other alpha-hemolytic or nonhemolytic streptococci are emphasized. A simple laboratory schema for rapid recognition of such pathogens is reviewed.- - - - - - - - - - ranking = 3keywords = hemolytic (Clic here for more details about this article) |
5/268. Acute bacterial meningitis secondary to gamma hemolytic streptococcus. Case report and review of the literature.Gamma hemolytic streptococcal meningitis in a 17-year-old boy resulted in a severe purulent reaction and death. review of the literature shows only one other case of a gamma hemolytic streptococcus as the cause of bacterial meningitis in the absence of endocarditis.- - - - - - - - - - ranking = 6keywords = hemolytic (Clic here for more details about this article) |
6/268. endophthalmitis after phakic intraocular lens implantation to correct high myopia.A 36-year-old woman had uneventful implantation of an angle-supported anterior chamber phakic intraocular lens (IOL) to correct high myopia. On the first postoperative day, she developed infectious endophthalmitis likely associated with intraoperative contamination. Group B beta-hemolytic streptococcus endophthalmitis was confirmed by microbiologic studies. To our knowledge, this is the first documented case of infectious endophthalmitis after anterior chamber phakic IOL implantation to correct high myopia.- - - - - - - - - - ranking = 1keywords = hemolytic (Clic here for more details about this article) |
7/268. Toxic shock-like syndrome resembling phlegmasia cerulea dolens.A case of a 71-year-old Japanese woman with toxic shock-like syndrome is reported. She was admitted to the hospital because of swelling of the right leg. On admission, right lower leg was erythematous and swollen with an erosive lesion. On the second day, she rapidly fell into shock. Phlegmasia cerulea dolens caused by massive iliofemoral venous thrombosis was suspected because she had a history of deep venous thrombosis. But deep venous thrombus was not detected by venography at emergent surgery for thromboembolectomy. She died 38 hours after admission despite maximal supportive therapy. Group A beta-hemolytic streptococci were isolated from blood culture and soft tissue after the patient died.- - - - - - - - - - ranking = 1keywords = hemolytic (Clic here for more details about this article) |
8/268. Characterization of blood culture isolates of streptococcus dysgalactiae subsp. equisimilis possessing Lancefield's group A antigen.For three human blood culture isolates of beta-hemolytic streptococci with Lancefield's serogroup A antigen, phylogenetic analysis of the 16S rRNA genes confirmed biochemical identification as streptococcus dysgalactiae subsp. equisimilis. genes encoding M or M-like proteins, which are considered to be major virulence determinants in streptococci, were detected in all of these strains. Our data clearly demonstrate that for beta-hemolytic streptococci, the species assignment should not be based on the results of serogrouping alone.- - - - - - - - - - ranking = 2keywords = hemolytic (Clic here for more details about this article) |
9/268. Case series: increased vulnerability to obsessive-compulsive symptoms with repeated episodes of Sydenham chorea.The association between obsessive-compulsive symptoms (OCS) and Sydenham chorea (SC) supports the hypothesis of a common neuroimmunological dysfunction in basal ganglia associated with group A beta-hemolytic streptococcal infection underlying both conditions. Four children with 2 distinct SC episodes were evaluated to assess the course of OCS. All patients developed OCS during their second episodes (3 met criteria for obsessive-compulsive disorder [OCD]), but not in their first episodes (2 developed OCS and met criteria for OCD). These data suggest that the recurrence of SC episodes may result in a cumulative effect, thus increasing the risk of appearance and intensification of OCS.- - - - - - - - - - ranking = 1keywords = hemolytic (Clic here for more details about this article) |
10/268. risk factors for maternal colonization with group B beta-hemolytic streptococci.Colonization with group B beta-hemolytic streptococci (GBS) at any time during pregnancy is an important risk factor for neonatal sepsis. To determine which groups of pregnant women are at high risk for GBS, a retrospective chart review was conducted on 608 pregnant women who had recorded data on prenatal charts and were seen between October 1995 and December 1997 at a family practice-run prenatal clinic. A total of 543 subjects were studied after exclusion of women who had no results of GBS colonization recorded. Demographically, the study population comprised 91.1% white non-Hispanic, 4.8% African-American, 1.5% Asian, and 2.6% white Hispanic women; 28.9% were primiparas, 38.9% unmarried; 60.0% low income; 31.1% smokers, 7.7% with a history of drug or alcohol use; 8.4% with a history of sexually transmitted disease; and 27.2% with fewer than 11 prenatal visits. The mean age was 26.4 years (range, 14 to 42 years). Seventy-six (14.0%) of the study subjects were colonized with GBS. White non-Hispanic women had a GBS colonization prevalence of 13.6%; for all others, prevalence was 18.7%. No statistically significant differences were found in regard to age, weight, number of prenatal visits, income level, marital status, history of drug use, or parity. The GBS colonization rate for smokers was 33.1% versus 16.4% for nonsmokers (P = .012). Maternal colonization of GBS was not found to be associated with any of the risk factors studied, other than smoking. This study identified smoking as a possible risk factor for GBS infection. Routine screening for GBS infection during pregnancy may be beneficial because no strong risk factors for colonization exist.- - - - - - - - - - ranking = 5keywords = hemolytic (Clic here for more details about this article) |
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