Toxic Shock Syndrome Caused by Streptococcus dysgalactiae Subspecies equisimilis: A Report of a Rare Pediatric Case
Bibliographic record
Abstract
Streptococcal toxic shock syndrome (STSS) is a severe invasive infection that has a high mortality rate. It is mainly caused by Streptococcus pyogenes. Nevertheless, STSS is also known to be caused by a group G Streptococcus identified as Streptococcus dysgalactiae subsp. equisimilis (SDSE). Invasive SDSE infection predominantly occurs in elderly individuals but is extremely rare in children. Furthermore, reports on STSS caused by SDSE are limited; hence, the clinical aspects and type of invasive mature M protein (emm) gene involved are unknown. A five-year-old girl with Down syndrome, tracheomalacia, and laryngomalacia presented to the emergency department with generalized edema of her face and upper body. She had undergone a tracheostomy and was receiving home ventilation. On admission, she showed hypotension (64/22 mmHg) with impaired consciousness. Blood testing showed elevated levels of inflammatory markers. Blood culture revealed the presence of SDSE and she was consequently diagnosed with STSS. The patient responded well to treatment and was discharged three weeks after admission. The emm subtype of the isolated SDSE strain was stC1400, with mutations in csrS and streptolysin S regulatory RNA in group G Streptococcus (srrG) genes. In this article, we report a case of STSS in a child caused by the stC1400 strain of SDSE.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.002 |
| Meta-epidemiology (narrow) | 0.003 | 0.002 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.003 | 0.002 |
| Science and technology studies | 0.002 | 0.002 |
| Scholarly communication | 0.001 | 0.002 |
| Open science | 0.001 | 0.002 |
| Research integrity | 0.004 | 0.003 |
| Insufficient payload (model declined to judge) | 0.002 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".