A case of toxic shock-like syndrome presenting with serious hypoproteinaemia because of a protein-losing gastroenteropathy

J Intern Med. 2001 Aug;250(2):174-9. doi: 10.1046/j.1365-2796.2001.00857.x.

Abstract

A 37-year-old man was admitted to our hospital because of toxic shock-like syndrome (TSLS) induced by Streptococcus pyogenes. After the pathogenic bacteria had been eradicated, serious diarrhoea appeared and a protein-losing gastroenteropathy developed. An immunohistochemical study of the biopsy specimens of both small and large intestines revealed the infiltration of T-lymphocytes, predominantly CD8+ cells, into the lamina propria of affected mucosa, villus atrophy and crypt hyperplasia. Considering these histological findings, some immunological mechanism which lead the activation of cytotoxic T-lymphocytes may play an important role in the pathogenesis of this rare intestinal manifestation of TSLS.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Anti-Bacterial Agents / therapeutic use
  • Colon / pathology
  • Diagnosis, Differential
  • Diarrhea / microbiology*
  • Diarrhea / pathology
  • Duodenum / pathology
  • Endoscopy, Gastrointestinal
  • Humans
  • Hypoproteinemia / drug therapy
  • Hypoproteinemia / microbiology*
  • Hypoproteinemia / pathology
  • Immunohistochemistry
  • Male
  • Shock, Septic / complications*
  • Shock, Septic / diagnosis*
  • Shock, Septic / drug therapy
  • Shock, Septic / microbiology
  • Shock, Septic / pathology
  • Streptococcal Infections / complications*
  • Streptococcal Infections / diagnosis*
  • Streptococcal Infections / drug therapy
  • Streptococcal Infections / pathology
  • Streptococcus pyogenes

Substances

  • Anti-Bacterial Agents