Article in Japanese

Fulminant hemolytic streptococcal infection in a one-month-old infant

Sara INOI^1,2）, Ryo NAKATANI^1,3）, Ikuko INAI^1）

A one-month-old male infant with umbilicitis was treated with steroid ointment from day 34 of life. He was hospitalized with fever and erythema from the lower abdomen to the groin area on day 36 of life. He was diagnosed with cellulitis, and administered cefazolin. Rashes on the upper and lower extremities were observed on day 2 of admission. Gram-positive cocci were detected on blood culture at the time of admission, and the cefazolin was changed to cefotaxime. On day 3, the patient developed impaired consciousness, tachycardia and respiratory distress. A blood culture result confirmed Streptococcus pyogenes, leading to a diagnosis of fulminant hemolytic streptococcal infection. Clindamycin and immunoglobulin were added, and the symptoms improved on day 4. It was concluded that fulminant hemolytic streptococcal infection should be considered as a differential diagnosis if an infant has fever, erythema and lethargy.

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1）Department of Pediatrics, St. Lukeʼs International Hospital
2）Department of Pediatrics, Tokyo Womenʼs Medical University
3）Department of Pediatric Nephrology, Tokyo Womenʼs Medical University

Key words	fulminant hemolytic streptococcal infection, Streptcoccus pyogenes, clindamycin, immunoglobulin
Received	September 5, 2022
Accepted	March 29, 2023

35 (2)：149─155,2023