@entity137 is a severe @entity166 . We report a Japanese case of @entity137 caused by a highly mucoid strain of @entity4195 . A 31-year old female with shock vital sign presented at a tertiary medical center. Her left breast was necrotizing and @entity4195 was detected by Immunochromatographic rapid diagnostic kits. Intensive care, including administration of antibiotics and skin debridement, was performed. After 53 days in our hospital, she was discharged. The blood cultures and skin swab cultures all grew @entity4195 which displayed a highly mucoid morphology on culture media. In her course of the disease, the @entity4195 strain had infected two other family members. All of the strains possessed the T1 and M1 antigens, as well as the emm1.0 gene. As for fever genes, the strains were all positive for speA, speB, and speF, but negative for speC. All of the strains exhibited and the same pattern in PFGE with the SfiI restriction enzyme. The strain might have spread in the local area by the data from the Japanese Infectious Disease Surveillance Center. Immunochromatographic rapid diagnostic kits are very useful for detecting @entity4195 . However, they can not be used to diagnose severe streptococcul disease by highly mucoid strain alone. Careful observation of @entity1 and colony morphology are useful methods for diagnosing severe @entity883 by highly mucoid strain.

XXXX from necrotizing soft-tissue infection of the breast caused by a mucoid type strain.

@entity1 :: ('9606', 'Species') :: ['patients'] @entity137 :: ('MESH:D064420', 'Disease') :: ['Streptococcal toxic shock syndrome'] @entity883 :: ('MESH:D013290', 'Disease') :: ['streptococcal disease'] @entity4195 :: ('1314', 'Species') :: ['Streptococcus', 'Streptococcus pyogenes', 'S. pyogenes', 'S.  pyogenes'] @entity166 :: ('MESH:D003141', 'Disease') :: ['infectious disease']
@entity137 :: (MESH:D064420,Disease) :: ['Streptococcal toxic shock syndrome']
