Since the beginning of December 2022, an unusually high number of cases and deaths of Group A Streptococcus (GAS) infections has been reported in many European countries. GAS infection frequently causes mild diseases such as pharyngitis, tonsillitis, impetigo, cellulitis, and scarlet fever. However, in rare instances, GAS infection can lead to invasive, life-threatening conditions like necrotizing fasciitis and toxic shock syndrome, which are associated with high mortality. The aim of the study was to present the clinical course of invasive Streptococcus pyogenes infections and to highlight the increase in the incidence of severe infections of this etiology, similar to trends observed in other European countries. The study included 11 patients with severe, invasive infections caused by S. pyogenes accompanied by sepsis or septic shock, treated at the 4th Clinical Military Hospital in Wroclaw between December 2022 and May 2023. Among 11 patients, 6 had streptococcal skin and soft tissue infections, 3 had pneumonia caused by S. pyogenes, 1 had streptococcal otitis, and 1 had a knee joint infection. Nine developed septic shock, and three died from fulminant streptococcal toxic shock syndrome (STSS). Physicians should be aware of the increased prevalence of invasive GAS (iGAS) infections; timely diagnosis and effective treatment are crucial to reducing the risk of severe complications, including death.
The vascular access port implantation procedure can be performed using the venesection method by inserting a catheter into the cephalic vein in the region of the deltopectoral groove. This method eliminates the need for catheter tunneling. An alternative method to infiltration anaesthesia for port implantation may be a modified pectoral nerve block type II (PECS II). This study aimed to evaluate the effectiveness of modified PECS II for vascular access port implantation using cephalic vein venesection. This retrospective observational study was conducted at the 4th Military Clinical Hospital in Wroclaw, Poland. A group of 114 patients underwent the modified PECS II block and additional cutaneous infiltration anesthesia at the incision line. Pain intensity was assessed on the NRS scale measured intraoperatively at four points. The QoR-15 questionnaire was used to assess patient satisfaction during the first 24 h after surgery. The operator’s condition assessment score was used to assess surgical conditions and operator comfort. The analysis showed that the median pain intensity during vascular port implantation was 0. A statistically significant difference in pain intensity was demonstrated between the specialist’s group and the resident’s group at the second and third measurement points (p < 0.008; p < 0.012). The mean value on the QoR-15 scale was 132. There was a significant difference between the pain scores of the groups. The mean score in the pain position in the specialist’s group was 18 points and in the resident’s group, it was 19 points (p < 0.029). In conclusion, the present study revealed that the modified PECS II block is an effective and safe method of anesthesia for Port-A-Cath implantation.