Toxic Shock Syndrome From Group C Streptococcus

We present a patient who was admitted with lower extremity cellulitis and was found to have Group C Streptococcus bacteremia causing toxic shock syndrome. Our patient was started on appropriate antibiotics, which included piperacillin/tazobactam, vancomycin, and clindamycin for presumed cellulitis, and was later transitioned to meropenem on day two when she was found to have gram-positive group C bacteremia and was treated for 14 days. Additionally, she was initiated on a three-day regimen of intravenous immunoglobulin (IVIG) as an adjunctive treatment for worsening clinical status from toxic shock syndrome. Our patient survived up to 46 days post admission but ultimately succumbed to her illness. It is worthwhile to state that the addition of IVIG could have prolonged her survival. We emphasize the importance of timely diagnosis and treatment with antibiotics and IVIG to help prevent mortality from this condition.