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Severe group A streptococcal infections in a paediatric intensive care unit.
- Source :
-
Journal of paediatrics and child health [J Paediatr Child Health] 2014 Sep; Vol. 50 (9), pp. 687-92. Date of Electronic Publication: 2014 Jun 09. - Publication Year :
- 2014
-
Abstract
- Aim: To describe the clinical presentation, management and outcomes for children with invasive group A streptococcal (GAS) infection in a paediatric intensive care unit (PICU).<br />Methods: We reviewed the clinical and laboratory records of patients admitted to a PICU in Melbourne with invasive GAS infection from April 2010 to April 2013. Outcomes recorded included survival, organ failure, need for extracorporeal support, renal replacement therapy and prolonged neuromuscular weakness.<br />Results: Twelve cases of invasive GAS infection were identified. The most common clinical presentations were pneumonia (n=5), bacteraemia with no septic focus (n=4) and septic arthritis (n=3). Necrotising fasciitis occurred in one patient and another patient presented with ischaemic lower limbs requiring amputation. Of the eight isolates with available emm typing results, the most common emm type was emm1 (n=4) followed by emm4, 12 and 22. Nine patients had multi-organ failure. Ten patients required mechanical ventilation for a median duration of 8 days. Nine patients required inotropic and/or vasopressor support and four patients extracorporeal membrane oxygenation support. Eleven patients survived. A prolonged period of neuromuscular weakness following the initial severe illness was common (n=5), but most children returned to normal or near normal neurological function.<br />Conclusions: Invasive GAS disease in children may cause severe multi-organ failure with resultant prolonged intensive care stay and significant morbidity. However, a high rate of survival and return to normal functioning may be achieved with multi-system intensive care support and multi-disciplinary rehabilitation.<br /> (© 2014 The Authors. Journal of Paediatrics and Child Health © 2014 Paediatrics and Child Health Division (Royal Australasian College of Physicians).)
- Subjects :
- Australia epidemiology
Child
Child, Preschool
Extracorporeal Membrane Oxygenation
Female
Hospitalization
Humans
Infant
Male
Renal Replacement Therapy
Streptococcal Infections mortality
Streptococcal Infections therapy
Intensive Care Units, Pediatric statistics & numerical data
Streptococcal Infections epidemiology
Streptococcus pyogenes
Subjects
Details
- Language :
- English
- ISSN :
- 1440-1754
- Volume :
- 50
- Issue :
- 9
- Database :
- MEDLINE
- Journal :
- Journal of paediatrics and child health
- Publication Type :
- Academic Journal
- Accession number :
- 24909187
- Full Text :
- https://doi.org/10.1111/jpc.12601