Toxic shock syndrome and streptococcal myositis: three case reports

Related Experiment Video

Updated: Sep 29, 2026

Implementation of a Permeable Membrane Insert-based Infection System to Study the Effects of Secreted Bacterial Toxins on Mammalian Host Cells
09:25

Implementation of a Permeable Membrane Insert-based Infection System to Study the Effects of Secreted Bacterial Toxins on Mammalian Host Cells

Published on: August 19, 2016

Ryan Watkins1, Harish Vyas

  • 1Department of Child Health, University Hospital, Nottingham NG7 2UH, UK. ryanw@doctors.org.uk

European Journal of Pediatrics
|August 30, 2002
PubMed

Insights

Group A Streptococcus (GAS) can cause severe toxic shock syndrome, particularly with myositis. Early recognition and intensive care are crucial for managing this rare but serious condition in children.

Area of Science:

  • Infectious Diseases
  • Microbiology
  • Critical Care Medicine

Background:

  • Group A Streptococcus (GAS) is a common cause of bacterial pharyngitis.
  • GAS infections can lead to serious post-infective sequelae like rheumatic fever and glomerulonephritis.
  • While rare in children, severe GAS disease, including toxic shock syndrome (TSS), can occur.

Observation:

  • This study presents three pediatric cases of toxic shock syndrome (TSS).
  • The TSS cases were secondary to Group A Streptococcus (GAS) myositis.
  • These cases highlight a specific, severe manifestation of GAS infection.

Findings:

  • The findings underscore that GAS myositis can precipitate TSS.
  • Early identification of GAS-related TSS is critical for timely intervention.
  • Prompt intensive care management is essential for patient survival and recovery.

Implications:

  • The study emphasizes the need for heightened clinical suspicion for TSS in pediatric GAS myositis cases.
  • It reinforces the importance of prompt diagnostic workup and aggressive supportive care in severe GAS infections.
  • This case series contributes to understanding the spectrum of GAS disease and informs clinical practice guidelines for pediatric infectious diseases and critical care.
Abstract

Related Concept Videos

Staphylococcal Skin Infections01:29

Staphylococcal Skin Infections

Staphylococcus aureus is a Gram-positive coccus that resides harmlessly on the skin and mucous membranes of healthy individuals. When the skin barrier is breached, it can shift from a commensal to an opportunistic pathogen. This transition is facilitated by surface adhesins, such as clumping factor B and S. aureus surface protein G (SasG), which bind to structural proteins, including loricrin and cytokeratin, in the damaged epidermis. Protein A, another key factor, binds the Fc region of...
Streptococcal Pharyngitis01:27

Streptococcal Pharyngitis

Streptococcal pharyngitis, commonly known as “strep throat,” is an acute infection of the oropharyngeal tissues caused by the Gram‑positive Group A Streptococcus (Streptococcus pyogenes). Transmission occurs primarily through respiratory droplets expelled during coughing, sneezing, or talking.Mechanisms of Host Entry and Immune EvasionUpon entering the host, S. pyogenes adheres to the mucosal epithelial cells of the pharynx via surface proteins, notably lipoteichoic acid and the antiphagocytic...
Rocky Mountain Spotted Fever01:26

Rocky Mountain Spotted Fever

Rocky Mountain Spotted Fever (RMSF) is a severe tick-borne illness caused by Rickettsia rickettsii, a Gram-negative, coccobacillary bacterium. This pathogen is an obligate intracellular parasite, requiring a host cell for replication. Transmission occurs through the bite of an infected tick. In the United States, the most important vectors are Dermacentor variabilis (American dog tick) and Dermacentor andersoni (Rocky Mountain wood tick), though other tick species may also serve as vectors.
Myocarditis III: Medical Management01:14

Myocarditis III: Medical Management

Myocarditis: Comprehensive Medical ManagementMyocarditis, the heart muscle inflammation, requires a comprehensive medical management strategy that addresses the underlying cause, provides supportive care, manages symptoms, and reduces cardiac workload.Infections and Autoimmune CausesAdminister appropriate antimicrobial therapy when an infectious agent causes myocarditis. For instance, penicillin treats infections caused by Group A Streptococcus. In cases where autoimmune processes are...
Diphtheria01:28

Diphtheria

Diphtheria is an acute, toxin-mediated infectious disease that primarily affects the upper respiratory tract. It is caused by Corynebacterium diphtheriae, a Gram-positive, pleomorphic rod that lacks spore-forming capability and exhibits a characteristic club-shaped morphology under microscopic examination. While C. diphtheriae can asymptomatically colonize mucosal surfaces, clinical disease manifests only when the bacterial strain is lysogenized by a specific β-corynephage. This phage...
Bacterial Gastroenteritis01:18

Bacterial Gastroenteritis

Bacterial gastroenteritis, characterized by diarrhea, abdominal cramps, and vomiting, is often caused by ingestion of contaminated food or water and is frequently associated with pathogenic Escherichia coli strains. These microbes exploit two principal mechanisms to inflict disease.Shiga toxin–producing E. coli, also referred to as STEC—notably O157:H7—release Shiga toxins that target ribosomes, blocking protein synthesis. The B subunit of the toxin binds the host glycolipid receptor...