Síndrome de shock tóxico estreptocócico letal en pediatría. Presentación de 3 casos

Three cases of children admitted to the Pediatric Intensive Medicine Unit in the months of February to March 2004 with the diagnosis of streptococcal toxic shock syndrome are presented. Two were under 2 years of age and the initial symptoms suggested viriasis. They evolved towards septic shock with early multiorganic failure and then death due to massive hemoptysis, ventricular fibrillation due to hyperkaliemia. Streptococcus pyogenes with serotypes M1T1 was isolated in all the cases and the patients had the clinical criteria of streptococcal toxic shock syndrome. Their course was unfavorable in spite of the resuscitation steps, early antibiotic treatment and artificial support of the different organic failures. We stress the rareness of the cases, early age, its appearance in a short period of time, its sudden onset and the null response to treatment initiated.