Toxic shock like syndrome caused by Streptococcus agalactiae bacteremia during treatment for multiple myeloma.

Toxic shock-like syndrome (TSLS) is a life-threatening hyperinflammatory complication caused by Streptococcus species infections. We reported the first case of TSLS caused by primary bacteremia of Streptococcus agalactiae during chemotherapy for multiple myeloma. A 74-year-old woman, who received combination chemotherapy of elotuzumab, pomalidomide, and dexamethasone for treatment-refractory multiple myeloma, was transported to our hospital under comatose and septic shock. Her blood culture detected Streptococcus agalactiae, and considering the progressive multiorgan failure, she was diagnosed with TSLS. Empiric antibiotic treatment with meropenem and respiratory and circulatory support were quickly initiated, resulting in an almost complete recovery of organ functions. It should be noted that with the advances of chemotherapy, the risk of infection is becoming more diverse.
Competing Interests: Declaration of competing interest M.K. received lecture fees from Bristol-Myers Squibb Co.; and lecture fees and research funding from Sumitomo Dainippon Pharma Co., Ltd. K.M. received non-financial support from Nichi-Iko Pharmaceutical Co., Ltd.; and research funding from Sumitomo Dainippon Pharma Co., Ltd. Y.M. received lecture fees from Bristol-Myers Squibb Co. None of these are related to the current study. Other authors declare that there is no conflict of interest.
(Copyright © 2022 Japanese Society of Chemotherapy and The Japanese Association for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.)