Correct!
4. Addition of clindamycin
The addition of clindamycin for its inhibition of bacterial protein synthesis is crucial to reduce the severity of the disease (2-4). Linezolid otherwise, would be preferred in areas of high clindamycin resistance. The other choices do not act specifically to inhibit protein synthesis.
The mortality rate of toxic shock like syndrome secondary to Group B Streptococcus agalactiae approaches 50% in review of current literature with rates of infection anywhere from 22 to 30 per 10,000 patients per population (2-4). There are no current vaccinations available to patients for prevention of this encapsulated organism like there is for Haemophilus influenza, Neisseria meningiditis, and Streptococcus pneumoniae.
References
- Levi M, Ten Cate H. Disseminated intravascular coagulation. N Engl J Med. 1999 Aug 19;341(8):586-92. [CrossRef] [PubMed]
- Al Akhrass F, Abdallah L, Berger S, Hanna R, Reynolds N, Thompson S, Hallit R, Schlievert PM. Streptococcus agalactiae toxic shock-like syndrome: two case reports and review of the literature. Medicine (Baltimore). 2013 Jan;92(1):10-4. [CrossRef] [PubMed]
- Shenoy R, Agarwal N, Goneppanavar U, Shenoy A, Sharma A. Symmetrical peripheral gangrene-a case report and brief review. Indian J Surg. 2013 Jun;75(Suppl 1):163-5. [CrossRef] [PubMed]
- Sims KD, Barton TD. Group B streptococcal toxic shock syndrome in an asplenic patient: case report and literature review. Eur J Clin Microbiol Infect Dis. 2006 Mar;25(3):208-10. [CrossRef] [PubMed]
- Gelinas JP, Russell JA. Vasopressors during sepsis: selection and targets. Clin Chest Med. 2016 Jun;37(2):251-62. [CrossRef] [PubMed]
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