Toxic shock syndrome secondary to Group A Streptococcus infection: A case report

Toxic shock syndrome secondary to Group A Streptococcus infection is a rare but serious cause of women's morbidity and mortality which can easily be misdiagnosed. A 37-year-old woman presented to the emergency department in a state of shock after a two-day history of abdominal pain, fever, diarrhoea and green vaginal discharge. Following extensive investigations, she was proved to have septic shock secondary to Group A Streptococcus pyogenes. Despite receiving intravenous antibiotics, she required explorative laparotomy, which proceeded to subtotal hysterectomy and bilateral salpingectomy. Subsequently, she developed multi-organ failure, disseminated intravascular coagulation, and limb ischemia requiring below-knee amputation of the right limb. She was discharged home. The aim of this report is to raise the awareness about toxic shock syndrome from Streptococcus pyogenes. A high index of suspicion is required to promptly diagnose this rare yet potentially fatal infection.