Simultaneous Streptococcus and Picornavirus Infection

Authors:
  • CPCharles B. Porter
    Charles B. Porter
  • DHDaniel R. Hinthorn
    Daniel R. Hinthorn
  • GCGuillermo Couchonnal
    Guillermo Couchonnal
  • IWItaru Watanabe
    Itaru Watanabe
  • ECE. Anne Caveny
    E. Anne Caveny
  • BGBarry Goldman
    Barry Goldman
  • RLRay Lash
    Ray Lash
  • FHFred Holmes
    Fred Holmes
  • CLChien Liu
    Chien Liu
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Abstract
Streptococci seldom invade muscle in healthy people with intact integument. However, infection with another agent simultaneously may change this general observation. In a two-week period we encountered dual infections with group A, β-hemolytic streptococci and a picornavirus in each of two hospitalized patients. Both were acutely ill; one died. Renal failure developed in the patient who survived and rhabdomyolysis was demonstrated in the patient who died. Picornavirus titer increases were demonstrated in the patient who survived, and viral inclusions in muscle cells were demonstrated by light microscopy in necropsy specimens and confirmed by electron microscopy in the second patient. We believe that streptococcal invasion of muscle may be facilitated during an outbreak of certain picornavirus infections. (JAMA1981;245:1545-1547)

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