Pediatric Infection and Vaccine

  • 제16권2호
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  • Pages.210-214
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  • 2009
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  • 2384-1079(pISSN)
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  • 2384-1087(eISSN)
대한소아감염학회 (The Korean Society of Pediatric Infectious Diseases)
권호 표지

일측성 편마비를 동반한 A군 ${\beta}$-용혈성 사슬알균 수막뇌염 1례

Group A ${\beta}$-hemolytic Streptococcal Meningoencephalitis with Unilateral Hemiparesis

  • 김기원 (연세대학교 원주의과대학 소아청소년과학교실) ;
  • 순유진 (연세대학교 원주의과대학 소아청소년과학교실) ;
  • 차병호 (연세대학교 원주의과대학 소아청소년과학교실) ;
  • 이해용 (연세대학교 원주의과대학 소아청소년과학교실) ;
  • 어영 (연세대학교 원주의과대학 진단검사의학교실) ;
  • 김선주 (경상대학교 의과대학 진단검사의학교실) ;
  • 전진경 (연세대학교 원주의과대학 소아청소년과학교실)
  • Kim, Ki-Won (Department of Pediatrics and Adolescent Medicine, Wonju Christian Hospital, Yonsei University Wonju College of Medicine) ;
  • Soon, Eu-Gene (Department of Pediatrics and Adolescent Medicine, Wonju Christian Hospital, Yonsei University Wonju College of Medicine) ;
  • Cha, Byung Ho (Department of Pediatrics and Adolescent Medicine, Wonju Christian Hospital, Yonsei University Wonju College of Medicine) ;
  • Lee, Hae Yong (Department of Pediatrics and Adolescent Medicine, Wonju Christian Hospital, Yonsei University Wonju College of Medicine) ;
  • Uh, Young (Department of Laboratory Medicine, Wonju Christian Hospital, Yonsei University Wonju College of Medicine) ;
  • Kim, Sunjoo (Department of Laboratory Medicine, Gyeongsang National University School of Medicine) ;
  • Chun, Jin-Kyong (Department of Pediatrics and Adolescent Medicine, Wonju Christian Hospital, Yonsei University Wonju College of Medicine)
  • 투고 : 2009.10.14
  • 심사 : 2009.11.03
  • 발행 : 2009.12.25
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초록

저자들은 건강하던 8세 남아에서 A군 $\beta$-용혈성 사슬알균(Group A $\beta$-hemolytic streptococci, GABHS) 감염 후 발생한 일련의 면역반응으로 인한 응고장애와 좌측 편마비 및 경련이 발생한 수막뇌염을 경험하여 문헌고찰과 함께 보고하는 바이다.

Group A streptococcus (GAS) rarely causes meningoencephalitis in children without risk factors. A previously healthy 8 year-old child presented with lethargy, high fever, and vomiting. The clinical course was unusual including intractable seizures, disseminated intravascular coagulation (DIC), and left hemiparesis in spite of the appropriate and timely administration of antibiotics and corticosteroids. The microbiologic studies revealed that the pathogen was susceptible to penicillin and GAS M18 strains. This case showed the importance of the GAS vaccine in addition to appropriate antibiotics.

키워드

참고문헌

  1. Ekelund K, Darenberg J, Norrby-Teglund A, Hoffmann S, Bang D, Skinhoj P, et al. Variations in emm type among group A streptococcal isolates causing invasive or noninvasive infections in a nationwide study. J Clin Microbiol 2005;43:3101-9. https://doi.org/10.1128/JCM.43.7.3101-3109.2005
  2. Abdissa A, Asrat D, Kronvall G, Shittu B, Achiko D, Zeidan M, et al. High diversity of group A streptococcal emm types among healthy schoolchildren in Ethiopia. Clin Infect Dis 2006;42: 1362-7. https://doi.org/10.1086/503422
  3. Hentgen V, Levy C, Bingen E, Cohen R. Group A streptococcal meningitis in children: clinical characteristics and outcome. Arch Pediatr 2008;15 Suppl 3:S154-7. https://doi.org/10.1016/S0929-693X(08)75499-X
  4. Carapetis JR, Steer AC, Mulholland EK, Weber M. The global burden of group A streptococcal diseases. Lancet Infect Dis 2005;5:685-94. https://doi.org/10.1016/S1473-3099(05)70267-X
  5. Perera N, Abulhoul L, Green MR, Swann RA. Group A streptococcal meningitis: case report and review of the literature. J Infect 2005;51:E1-4. https://doi.org/10.1016/j.jinf.2004.06.006
  6. Lee JS, Jang TY, Ahn YM. A case of deep vein thrombosis associated with myositis due to Streptococcus pyogenes. Korean J Pediatr Infect Dis 2009;16:87-91.
  7. Lamagni TL, Neal S, Keshishian C, Alhaddad N, George R, Duckworth G, et, al. Severe Streptococcus pyogenes infections, United Kingdom, 2003-2004. Emerg Infect Dis 2008;14:202-9. https://doi.org/10.3201/eid1402.070888
  8. O'Loughlin RE, Roberson A, Cieslak PR, Lynfield R, Gershman K, Craig A, et, al. The epidemiology of invasive group A streptococcal infection and potential vaccine implications: United States, 2000-2004. Clin Infect Dis 2007;45:853-62. https://doi.org/10.1086/521264
  9. Laupland KB, Ross T, Church DL, Gregson DB. Population- based surveillance of invasive pyogenic streptococcal infection in a large Canadian region. Clin Microbiol Infect 2006;12:224-30. https://doi.org/10.1111/j.1469-0691.2005.01345.x
  10. Santos MS, Ribeiro GS, Oliveira TQ, Santos RC, Gouveia E, Salgado K, et, al. Burden of group A streptococcal meningitis in Salvador, Brazil: report of 11 years of population-based surveillance. Int J Infect Dis 2009; 13:456-61. https://doi.org/10.1016/j.ijid.2008.09.006
  11. Baraldés MA, Domingo P, Mauri A, Monmany J, Castellanos M, Pericas R, et, al. Group A streptococcal meningitis in the antibiotic era. Eur J Clin Microbiol Infect Dis 1999;18:572-8. https://doi.org/10.1007/s100960050349
  12. Asnis DS, Knez T. Group A streptococcal meningitis. Arch Intern Med 1998;158:810, 3-4.
  13. Burnett AM, Domachowske JB. Therapeutic considerations for children with invasive group a streptococcal infections: a case series report and review of the literature. Clin Pediatr (Phila) 2007;46:550-5. https://doi.org/10.1177/0009922807299940
  14. Sela S, Barzilai A. Why do we fail with penicillin in the treatment of group A streptococcus infections? Ann Med 1999;31:303-7. https://doi.org/10.3109/07853899908995895
  15. Zimbelman J, Palmer A, Todd J. Improved outcome of clindamycin compared with beta-lactam antibiotic treatment for invasive Streptococcus pyogenes infection. Pediatr Infect Dis J 1999;18:1096-100. https://doi.org/10.1097/00006454-199912000-00014
  16. Shetty AK, Frankel LR, Maldonado Y, Falco DA, Lewis DB. Group A streptococcal meningitis: report of a case and review of literature since 1976. Pediatr Emerg Care 2001;17:430-4. https://doi.org/10.1097/00006565-200112000-00007
  17. Berner R, Herdeg S, Gordjani N, Brandis M. Streptococcus pyogenes meningitis: report of a case and review of the literature. Eur J Pediatr 2000;159:527-9. https://doi.org/10.1007/s004310051325
  18. Mathur P, Arora NK, Kapil A, Das BK. Streptococcus pyogenes meningitis. Indian J Pediatr 2004;71:423-6. https://doi.org/10.1007/BF02725632
  19. Kaul R, McGeer A, Norrby-Teglund A, Kotb M, Schwartz B, O'Rourke K, et, al. Intravenous immunoglobulin therapy for streptococcal toxic shock syndrome--a comparative observational study. The Canadian Streptococcal Study Group. Clin Infect Dis 1999;28:800-7. https://doi.org/10.1086/515199
  20. Bryant AE, Hayes-Schroer SM, Stevens DL. M type 1 and 3 group A streptococci stimulate tissue factormediated procoagulant activity in human monocytes and endothelial cells. Infect Immun 2003;71:1903-10. https://doi.org/10.1128/IAI.71.4.1903-1910.2003
  21. Turner CE, Kurupati P, Jones MD, Edwards RJ, Sriskandan S. Emerging role of the interleukin-8 cleaving enzyme SpyCEP in clinical Streptococcus pyogenes infection. J Infect Dis 2009;200:555-63. https://doi.org/10.1086/603541
  22. Beall B, Facklam R, Hoenes T, Schwartz B. Survey of emm gene sequences and T-antigen types from systemic Streptococcus pyogenes infection isolates collected in San Francisco, California; Atlanta, Georgia; and Connecticut in 1994 and 1995. J Clin Microbiol 1997;35: 1231-5.
  23. Falugi F, Zingaretti C, Pinto V, Mariani M, Amodeo L, Manetti AG, et, al. Sequence variation in group A Streptococcus pili and association of pilus backbone types with lancefield T serotypes. J Infect Dis 2008;198: 1834-41. https://doi.org/10.1086/593176
  24. Koh EH, Kim S. Distribution of T types and emm Genotypes of Streptococcus pyogenes in Jinju, 2004. Korean J Lab Med 2006;26:91-6.