{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,2,21]],"date-time":"2025-02-21T19:02:17Z","timestamp":1740164537717,"version":"3.37.3"},"reference-count":17,"publisher":"Wiley","license":[{"start":{"date-parts":[[2019,4,16]],"date-time":"2019-04-16T00:00:00Z","timestamp":1555372800000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Case Reports in Critical Care"],"published-print":{"date-parts":[[2019,4,16]]},"abstract":"<jats:p><jats:italic>Background<\/jats:italic>. Streptococcal toxic shock syndrome (STSS) is a rapidly progressive infection, with potentially rapid patient deterioration in a very short period. We experienced a rare case of STSS during anticancer chemotherapy, and we continuously measured presepsin (P-SEP) and evaluated its usefulness.<jats:italic> Case Presentation<\/jats:italic>. A 60-year-old woman with pulmonary metastasis from cervical cancer began anticancer chemotherapy. A fever of &gt;40\u00b0C and right lower leg swelling developed on day 3. Symptoms worsened despite cefmetazole treatment (1.0 g\/day). Blood culture was performed without suspecting STSS. On day 5, symptoms worsened and acute disseminated intravascular coagulation (DIC) and sequential organ failure assessment (SOFA) scores increased. C-reactive protein (CRP) increased from 28.8 mg\/dl to 35.5 mg\/dl and P-SEP also increased from 1,635 to 2,350 pg\/mL. STSS was suspected due to the rapid progression of brown discoloration of the entire right lower leg. Ceftriaxone 2 g\/day and clindamycin 1,200 mg\/day were begun. On the evening of day 5, blood culture revealed rapidly progressive group A streptococci. After that, symptoms improved rapidly with treatment, and SOFA and DIC scores also decreased. While CRP remained at about 0.5 mg\/dl, P-SEP remained slightly elevated at about 400 pg\/mL. A residual infection focus was suspected. Contrast-enhanced computed tomography (CT) revealed a capsule-enclosed abscess in the right lower leg soleus muscle on day 32. Debridement was performed and antibiotics were continued until P-SEP was 88 pg\/mL. CT confirmed the disappearance of the abscess.<jats:italic> Conclusion<\/jats:italic>. Prompt diagnosis by blood culture and a sufficiently early, appropriate change in antibiotic therapy led to successful recovery from STSS during anticancer chemotherapy without lower limb amputation. P-SEP was useful in assessment of the residual infection focus and suspending treatments.<\/jats:p>","DOI":"10.1155\/2019\/3240501","type":"journal-article","created":{"date-parts":[[2019,4,16]],"date-time":"2019-04-16T20:03:09Z","timestamp":1555444989000},"page":"1-5","source":"Crossref","is-referenced-by-count":1,"title":["A Patient of Using Presepsin to Diagnose Streptococcal Toxic Shock Syndrome during Anticancer Drug Treatment"],"prefix":"10.1155","volume":"2019","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5947-6295","authenticated-orcid":true,"given":"Gaku","family":"Takahashi","sequence":"first","affiliation":[{"name":"Department of Critical Care, Disaster and General Medicine, School of Medicine, Iwate Medical University, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","reference":[{"key":"1","doi-asserted-by":"crossref","first-page":"213","DOI":"10.3918\/jsicm.10.213","volume":"10","year":"2003","journal-title":"The Japanese Society of Intensive Care Medicine"},{"key":"2","doi-asserted-by":"publisher","DOI":"10.3919\/jjsa.64.2879"},{"key":"3","doi-asserted-by":"publisher","DOI":"10.1097\/01.ccm.0000202209.42491.38"},{"key":"4","doi-asserted-by":"publisher","DOI":"10.1007\/s001340050156"},{"key":"5","first-page":"1304","volume":"2009","year":"2009","journal-title":"Emerging Infectious Diseases Journal"},{"key":"6","doi-asserted-by":"crossref","first-page":"853","DOI":"10.1086\/521264","volume":"45","year":"2007","journal-title":"Clinical Infectious Diseases"},{"key":"7","doi-asserted-by":"publisher","DOI":"10.3201\/eid1402.070888"},{"key":"8","doi-asserted-by":"crossref","first-page":"390","DOI":"10.1001\/jama.1993.03500030088038","volume":"269","year":"1993","journal-title":"JAMA"},{"key":"9","doi-asserted-by":"publisher","DOI":"10.1111\/jog.12126"},{"key":"10","first-page":"1","volume":"24","year":"2016","journal-title":"The Japanese Society of Intensive Care Medicine"},{"key":"11","doi-asserted-by":"publisher","DOI":"10.1086\/376630"},{"key":"12","doi-asserted-by":"publisher","DOI":"10.1186\/2052-0492-1-4"},{"key":"13","doi-asserted-by":"publisher","DOI":"10.1073\/pnas.85.5.1657"},{"key":"14","doi-asserted-by":"publisher","DOI":"10.1007\/s10156-011-0254-x"},{"issue":"14","key":"15","first-page":"88","volume":"4","year":"2014","journal-title":"BMC Anesthesiology"},{"key":"16","doi-asserted-by":"publisher","DOI":"10.1016\/j.cca.2018.09.013"},{"key":"17","doi-asserted-by":"publisher","DOI":"10.1016\/j.diagmicrobio.2016.07.015"}],"container-title":["Case Reports in Critical Care"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/downloads.hindawi.com\/journals\/cricc\/2019\/3240501.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/downloads.hindawi.com\/journals\/cricc\/2019\/3240501.xml","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/downloads.hindawi.com\/journals\/cricc\/2019\/3240501.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2019,4,16]],"date-time":"2019-04-16T20:03:14Z","timestamp":1555444994000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.hindawi.com\/journals\/cricc\/2019\/3240501\/"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,4,16]]},"references-count":17,"alternative-id":["3240501","3240501"],"URL":"https:\/\/doi.org\/10.1155\/2019\/3240501","relation":{},"ISSN":["2090-6420","2090-6439"],"issn-type":[{"type":"print","value":"2090-6420"},{"type":"electronic","value":"2090-6439"}],"subject":[],"published":{"date-parts":[[2019,4,16]]}}}