Severe invasive streptococcal infection in a patient with COVID-19: A case report

A 63-year-old male with a history of hypertension had contracted Coronavirus Disease-2019 (COVID-19) five days before visiting our hospital and was recovering at home. He was brought to the hospital for emergency care because of bilateral leg pain, diarrhea, and shortness of breath. On arrival to the hospital, the patient was already suffering from multiple organ failure and was admitted to the intensive care unit. Streptococcus dysgalactiae subsp. equisimilis (SDSE) was detected in blood and sputum cultures, and we started antimicrobial therapy for septic shock/streptococcal toxic shock syndrome. However, multiple organ failure progressed, and the patient died one day after admission. This case suggests the possibility of immunosuppression due to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. The patient had no history of immunodeficiency, and COVID-19 may have contributed to the poor outcome. COVID-19 combined with SDSE sepsis has not been previously reported. Therefore, this case was considered rare.