Abstract
We report the case of a 24-years old diabetic women hospitalised because of right-sided lower abdominal pain and diarrhea. She fulminantly developed shock before appendectomy could be performed and was transferred to intensive care unit. Hypotension remained and laparoscopy revealed primary peritonitis and toxic shock syndrome by Group A Streptococcus which was cultivated in blood and ascites. Therapy with penicilline and clindamycine resolved symptoms. During hospitalisation Clostridium difficile colitis occurred. This complication leaded to prolonged hospitalisation.
MeSH terms
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Abdomen, Acute / etiology*
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Anti-Bacterial Agents / adverse effects
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Anti-Bacterial Agents / therapeutic use
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Appendicitis / diagnosis
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Bacteremia / diagnosis*
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Bacteremia / drug therapy
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Clostridioides difficile
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Diabetes Mellitus, Type 1 / diagnosis*
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Diagnosis, Differential
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Diarrhea / etiology*
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Enterocolitis, Pseudomembranous / chemically induced
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Enterocolitis, Pseudomembranous / diagnosis
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Female
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Humans
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Laparoscopy
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Necrobiosis Lipoidica / diagnosis
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Peritonitis / diagnosis*
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Peritonitis / drug therapy
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Shock, Septic / diagnosis*
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Shock, Septic / drug therapy
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Streptococcal Infections / diagnosis*
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Streptococcal Infections / drug therapy
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Streptococcus pyogenes*
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Ultrasonography
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Young Adult