<abstract xmlns="http://www.w3.org/1999/xhtml"><bold>Introduction</bold>: Streptococcal infection can be responsible for multiple complications, such as toxic, septic or allergic disorders. Toxin-mediated complications (TMC) can appear during the acute phase of disease and can involve any organ, causing carditis, arthritis, nephritis, hepatitis etc.<bold>Case presentation</bold>: The case of a young woman without a history of recurrent streptococcal tonsillitis, admitted to “Matei Balş” National Institute for Infectious Diseases, Bucharest, Romania, presenting with fever, sore throat and exudative tonsillitis, is detailed. The initial test for Streptococcus pyogenes was negative. The patient had leukopenia with severe neutropenia, high values of inflammatory biomarkers and electrocardiographic (ECG) changes with inverted T waves in leads V1-4 and flattened T waves in V5-6. There were no other cardiac signs or symptoms. The patient received cefuroxime for two days. On admission, the patient was prescribed Penicillin G and dexamethasone which resulted in a rapid recovery. The leucocytes count returned to normal as did the ECG abnormalities. At the time of discharge, the antistreptolysin O titre was high.<bold>Conclusions</bold>: The case highlights the toxin-mediated complications (TMC) of streptococcal infection which occur from the outset of the disease.</abstract>

Introduction: Streptococcal infection can be responsible for multiple complications, such as toxic, septic or allergic disorders. Toxin-mediated complications (TMC) can appear during the acute phase of disease and can involve any organ, causing carditis, arthritis, nephritis, hepatitis etc.Case presentation: The case of a young woman without a history of recurrent streptococcal tonsillitis, admitted to “Matei Balş” National Institute for Infectious Diseases, Bucharest, Romania, presenting with fever, sore throat and exudative tonsillitis, is detailed. The initial test for Streptococcus pyogenes was negative. The patient had leukopenia with severe neutropenia, high values of inflammatory biomarkers and electrocardiographic (ECG) changes with inverted T waves in leads V1-4 and flattened T waves in V5-6. There were no other cardiac signs or symptoms. The patient received cefuroxime for two days. On admission, the patient was prescribed Penicillin G and dexamethasone which resulted in a rapid recovery. The leucocytes count returned to normal as did the ECG abnormalities. At the time of discharge, the antistreptolysin O titre was high.Conclusions: The case highlights the toxin-mediated complications (TMC) of streptococcal infection which occur from the outset of the disease.

Neutropenia and T-Wave Inversion as Toxin-Mediated Complications of a Streptococcal Infection

“Carol Davila” University of Medicine and Pharmacy

“Prof. Dr. Matei Balş” National Institute for Infectious Diseases

The Journal of Critical Care Medicine

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 License.

Introduction: Streptococcal infection can be responsible for multiple complications, such as toxic, septic or allergic disorders. Toxin-mediated complications...

Neutropenia and T-Wave Inversion as Toxin-Mediated Complications of a Streptococcal Infection

Published Online: Nov 08, 2017

Page range: 166 - 171

Received: Aug 10, 2017

Accepted: Oct 23, 2017

DOI: https://doi.org/10.1515/jccm-2017-0030

Keywords
tonsillitis, streptococcal infection, leukopenia, toxic myocarditis

© 2017 Cristina Popescu et al., published by De Gruyter Open

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 License.

Neutropenia and T-Wave Inversion as Toxin-Mediated Complications of a Streptococcal Infection

Published Online: Nov 08, 2017

Page range: 166 - 171

Received: Aug 10, 2017

Accepted: Oct 23, 2017

DOI: https://doi.org/10.1515/jccm-2017-0030

Keywordstonsillitis, streptococcal infection, leukopenia, toxic myocarditis

© 2017 Cristina Popescu et al., published by De Gruyter Open

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 License.

Keywords
tonsillitis, streptococcal infection, leukopenia, toxic myocarditis