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Streptococcal Toxic Shock Syndrome Associated with Marked T Cell Expansion: Case Report

1996; Oxford University Press; Volume: 22; Issue: 2 Linguagem: Inglês

10.1093/clinids/22.2.362

1537-6591

Mardjan Arvand, Thomas Schneider, H Jahn, Helmut Hahn,

Botulinum Toxin and Related Neurological Disorders

Streptococcal toxic shock syndrome (strepTSS) has been associated with various streptococcal soft-tissue infections including cellulitis, necrotizing fasciitis, and peritonitis in adults. We describe a 40-year-old patient with pharyngitis and strepTSS. Throat swab cultures yielded a strain of Streptococcus pyogenes that produced large amounts of erythrogenic toxin A. Fluorescence-activated cell sorter analysis of the patient's peripheral blood lymphocytes revealed generally enhanced expression of the T cell activity markers CD2S and human leukocyte antigen-DR and a marked increase in the number of γδ T cells, largely of the VB1-bearing subpopulation. Two more analyses, which were performed 2 weeks and 9 months later, respectively, documented the course of normalization after the acute episode of strepTSS. The T cells of this patient were stimulated in vitro with supernatants of his streptococcal isolate, and they proliferated in a dose-dependent manner. These proliferating T cells were mainly αβ T cells.