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Necrotizing Fasciitis and Streptococcal Toxic Shock Syndrome: A Case Report
Raffaele Merola1, Clara De Negri2, Angelina Merola3
1Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples Federico II, Naples, ITA.
Abstract:
Group A Streptococcus (GAS), particularly Streptococcus pyogenes (S. pyogenes), is a significant human pathogen responsible for infections often ranging from mild superficial conditions to severe, life-threatening diseases like necrotizing fasciitis (NF) and streptococcal toxic shock syndrome (STSS). This case report details the rapid deterioration of a previously healthy 49-year-old woman who presented with localized symptoms in her left thigh, later escalating to septic shock and multi-organ failure related to GAS infection. Initial evaluations indicated significant inflammation and acute kidney injury, prompting broad-spectrum antibiotic treatment. Despite aggressive management and transfer to the intensive care unit, the patient succumbed to complications of STSS and NF. An autopsy confirmed systemic dissemination of S. pyogenes. This case underscores the urgent need for heightened clinical awareness and timely intervention in patients with rapid onset of severe infections, emphasizing the critical importance of public health initiatives to mitigate GAS-related morbidity and mortality. Future research should focus on understanding the pathophysiology and risk factors associated with severe GAS infections to develop targeted therapies.

