Title |
Streptococcal toxic-shock syndrome due to Streptococcus dysgalactiaesubspecies equisimilis in breast cancer-related lymphedema: a case report
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Published in |
Journal of Medical Case Reports, July 2017
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DOI | 10.1186/s13256-017-1350-z |
Pubmed ID | |
Authors |
Makoto Sumazaki, Fumi Saito, Hideaki Ogata, Miho Yoshida, Yorichika Kubota, Syunsuke Magoshi, Hironori Kaneko |
Abstract |
Breast cancer-related lymphedema often causes cellulitis and is one of the most common complications after breast cancer surgery. Streptococci are the major pathogens underlying such cellulitis. Among the streptococci, the importance of the Lancefield groups C and G is underappreciated; most cases involve Streptococcus dysgalactiae subspecies equisimilis. Despite having a relatively weak toxicity compared with group A streptococci, Streptococcus dysgalactiae subspecies equisimilis is associated with a mortality rate that is as high as that of group A streptococci in cases of invasive infection because Streptococcus dysgalactiae subspecies equisimilis mainly affects elderly individuals who already have various comorbidities. An 83-year-old Japanese woman with breast cancer-related lymphedema in her left upper limb was referred to our hospital with high fever and acute pain with erythema in her left arm. She showed septic shock with disseminated intravascular coagulation. Blood culture showed positive results for Streptococcus dysgalactiae subspecies equisimilis, confirming a diagnosis of streptococcal toxic-shock syndrome. She survived after successful intensive care. To the best of our knowledge, this case represents the first report of Streptococcus dysgalactiae subspecies equisimilis-induced streptococcal toxic-shock syndrome in a patient with breast cancer-related lymphedema. Breast cancer-related lymphedema is a common problem, and we must pay attention to invasive streptococcal soft tissue infections, particularly in elderly patients with chronic disease. |
Mendeley readers
Geographical breakdown
Country | Count | As % |
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Unknown | 56 | 100% |
Demographic breakdown
Readers by professional status | Count | As % |
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Student > Bachelor | 11 | 20% |
Researcher | 6 | 11% |
Student > Postgraduate | 6 | 11% |
Student > Ph. D. Student | 3 | 5% |
Student > Doctoral Student | 2 | 4% |
Other | 6 | 11% |
Unknown | 22 | 39% |
Readers by discipline | Count | As % |
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Medicine and Dentistry | 23 | 41% |
Nursing and Health Professions | 3 | 5% |
Agricultural and Biological Sciences | 2 | 4% |
Biochemistry, Genetics and Molecular Biology | 1 | 2% |
Pharmacology, Toxicology and Pharmaceutical Science | 1 | 2% |
Other | 0 | 0% |
Unknown | 26 | 46% |