Streptococcal Toxic Shock Syndrome with Initial Manifestation of Abdominal Pain and Cholecystitis
洪德育(Te-Yu Hung)；王麟玉(Lin-Yu Wang)；陳俊達(Chun-Ta Chen)；陳德人(Te-Jen Chen)
streptococcal toxic shock syndrome ； group A streptococcal infection ； anti-streptolysin O titer ； cholecystitis ； hydrops of the gallbladder
Acta Paediatrica Taiwanica
|Volume or Term/Year and Month of Publication||
46卷2期（2005 / 04 / 01）
106 - 110
Streptococcal toxic shock syndrome with the initial manifestation of abdominal pain and cholecystitis is rare. We report the case of a 10-year-old boy who presented with abdominal pain, cholecystitis and shock initially. Acute respiratory distress syndrome, renal and hepatic insufficiency and disseminated intravascular coagulation developed soon after admission. Skin rash and desquamation were found subsequently during the recovery phase. The blood and sputum cultures were sterile. Acute and convalescent plasma from the patient showed increased anti-streptolysin O titer (ASLO titer). Measurement of the ASLO titer on Day 11 after the onset of disease had an ASLO titer of 242 IU/ml (N Latex ASL, Dade Behring Marburg GmbH, USA), and the ASLO titer on Day 21 after the onset of disease showed an increase to 875 IU/ml. These clinical findings and the plasma analysis were consistent with streptococcal toxic shock syndrome.