Doctors in Connecticut have treated a seriously ill patient with the same rare and deadly flesh-eating infection that is spreading throughout Japan and leaving many patients dead within 48 hours.
Doctors reported the case (a 41-year-old female patient) in March, when Japanese authorities first warned of a rise in cases.
The woman visited the local emergency room after a week with vomiting, diarrhea and difficulty breathing.
Scans revealed fluid buildup on the left side of his lungs, as well as respiratory and kidney failure.
Doctors believe the woman’s illness was caused by streptococcal toxic shock syndrome (STSS), an extremely deadly bacterial infection that has so far killed 77 people in Japan this year, the highest number of cases in the country.
The patient’s CT scans revealed that fluid was filling the left side of her lungs. She soon suffered respiratory and kidney failure.
When the patient’s circulation was cut off, her toe began to turn black. Doctors believe it may need to be amputated.
The woman is believed to have contracted the virus behind the condition, called group A streptococcus, by breathing infected airborne droplets, which are expelled when sneezing, coughing and talking.
Before seeking emergency care, a pulmonologist had prescribed the woman the corticosteroid prednisone, along with antibiotics and a medication to widen her airways.
He reported asthma but no other chronic health problems.
However, her husband noticed that several family members had recently been diagnosed with strep throat, caused by the common bacteria group A Streptococcus (group A streptococcus).
At the hospital, the woman also had an elevated pulse and low blood pressure.
After three days in intensive care, the patient stopped urinating. One of his toes also began to turn black due to the disruption of circulation and tissue death.
Several days later, more tests revealed STSS due to an untreated respiratory infection.
Most group A strep infections cause mild illnesses such as strep throat.
However, when the bacteria spread to the blood and deep tissue, patients can develop STSS, which kills 30 percent of those affected.
STSS often begins with flu-like symptoms, such as fever, chills, muscle aches, nausea, and vomiting.
However, over time, blood pressure drops, while heart rate and breathing speed up, and vital organs such as the lungs may begin to fail. And as with the Connecticut patient, the disease attacks healthy tissue and eats away at flesh, sometimes requiring amputations.
The United States reported 145 cases of STSS in 2021, according to the latest data available from the CDC.
Cases have skyrocketed in Japan, where more than 1,000 people have been infected since the beginning of this year and 77 have died.
Although strep A can cause several serious illnesses, it tends to start with some typical symptoms. This includes a rash, sore throat, red cheeks, muscle aches, high fever, ear infection, and skin sores.
It’s unclear exactly what’s behind the Japanese surge, but Dr. Ken Kikuchi of Tokyo Women’s Medical University told local news outlet NHK that immunity debt from the Covid pandemic could be partly to blame.
Immune debt occurs when the immune system weakens after being exposed to a variety of pathogens.
‘We can increase immunity if we are constantly exposed to bacteria. But that mechanism was absent during the coronavirus pandemic,” Dr. Kikuchi said.
“Therefore, there are now more people susceptible to infection and that may be one of the reasons for the sharp increase in cases.”
However, American experts have stated that the increase is unlikely to spread to the United States and that the condition remains rare.
Dr. Andrew Steer, director of infection, immunity and global health at the Murdoch Children’s Research Institute in Australia, told the Washington Post: ‘We’ve had strep toxic shock syndrome and invasive strep A infection in the US for decades and decades and decades, hundreds of years.’
“It remains a rare infection, but the community and doctors need to be aware that there is an increase in the number of cases.”
And although cases are rising in Japan, experts have warned that influenza and Covid infections are much higher. For example, this year more than 746,000 Covid infections have been reported as of June 9, according to reports from more than 5,000 hospitals.
And Japan’s Health Ministry has assured tourists that there is no need to cancel their travel plans to the country. Bloomberg reported.
STSS often results from a person having an open wound and being exposed to the bacteria, giving it an easier way to infect deeper tissues.
However, in many cases, the exact cause of STSS cannot be identified.
US experts have urged patients to keep an eye on open wounds, making sure they are clean and bandaged effectively.
The Connecticut patient completed a course of antibiotics and in-patient rehabilitation, although doctors said she may need to have a toe amputated.
The case report was published in the magazine. Cureus.
