Toxic Shock Syndrome Due to Streptococcus pyogenes: A Case Series

Streptococcal toxic shock syndrome (STSS) is an acute and life-threatening illness with a high mortality rate. It is the result of an infection by group A Streptococcus, which can produce exotoxins with superantigen activity. Herein, we report three patient cases who presented to the emergency department with skin lesions and were in a state of shock. In each case, the clinical presentation indicated a diagnosis of toxic shock syndrome, which was posteriorly confirmed when Streptococcus pyogenes was isolated in their blood cultures. Only two of the cases were treated with clindamycin and an antibiotic in the penicillin group; these patients later presented with clinical improvement and had a full recovery. The cases presented demonstrate the rapid evolution of this syndrome, from a skin lesion to fulminant multi-organ failure. Hence, we highlight the need for alertness to this syndrome because once the patient has reached multi-organ failure, halting the disease progression may not be possible without proper treatment and assistance from a multidisciplinary team.