Rapid Clinical Recovery in Streptococcal Toxic Shock Syndrome With Intravenous Immunoglobulin (IVIG): A Case Report

Streptococcal toxic shock syndrome (STSS) is a rare but life-threatening condition, with an estimated incidence of 1-3 cases per 100,000 population annually and reported mortality rates exceeding 30% and reaching up to 44% in some series. It is characterized by rapid systemic deterioration due to toxin-producing Streptococcus pyogenes. Prompt recognition and escalation of therapy, including the use of adjunctive intravenous immunoglobulin (IVIG), are critical to improving outcomes. We report the case of a previously healthy 37-year-old man who presented with high-grade fever, hypotension, and a widespread erythematous rash. Initial antibiotic therapy targeting skin and soft tissue infection yielded a limited response. Culture from an ulcerated lesion confirmed beta-hemolytic Streptococcus. Despite broad-spectrum antibiotics and intensive care support, the patient continued to deteriorate. A diagnosis of STSS was made, and IVIG was administered with rapid clinical improvement. This case highlights the importance of early diagnosis, multidisciplinary management, and the potential role of IVIG in severe STSS.