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Toxic streptococcal syndrome.

U E Gallo1, P B Fontanarosa

  • 1Department of Emergency Medicine, Northeastern Ohio Universities College of Medicine, Akron City Hospital 44309.

Annals of Emergency Medicine
|November 1, 1990
PubMed
Summary

Group A Streptococcus can cause a toxic shocklike syndrome, similar to staphylococcal toxic shock syndrome. Emergency physicians should consider streptococcal infection in patients with toxic shocklike symptoms.

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Area of Science:

  • Infectious Diseases
  • Toxicology
  • Critical Care Medicine

Background:

  • Toxic shock syndrome (TSS) is a severe illness often linked to Staphylococcus aureus.
  • A similar condition, streptococcal toxic shocklike syndrome (STSS), has emerged as a distinct clinical entity.
  • STSS is caused by toxins from group A beta-hemolytic Streptococcus (GAS).

Observation:

  • This report details a patient meeting major criteria for toxic shock syndrome.
  • The patient presented with fever, hypotension, multisystem dysfunction, and characteristic rash with desquamation.
  • Serologic tests indicated a streptococcal infection.

Findings:

  • The patient's presentation and serologic findings strongly suggest GAS as the causative agent.
  • This case highlights the overlap in clinical features between staphylococcal and streptococcal toxic shock syndromes.
  • Group A Streptococcus should be considered in the differential diagnosis of toxic shocklike illness.

Implications:

  • Early recognition of STSS is crucial for prompt and appropriate treatment.
  • Considering GAS in patients with toxic shocklike syndrome can lead to faster diagnosis and intervention.
  • This underscores the importance of considering bacterial toxins in severe, multisystem inflammatory conditions.

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