Streptococcal toxic shock syndrome

Streptococcal toxic shock syndrome is a rare toxin-mediated disease that can develop following infection with a toxin-producing Streptococcus pyogenes (group A streptococcus) strain.

Diagnosis of streptococcal toxic shock syndrome requires isolation of S. pyogenes from a patient with hypotension and at least 2 of the following:

• kidney impairment
• coagulopathy
• hyperbilirubinaemia
• adult respiratory distress syndrome
• generalised rash or soft tissue necrosis.

Children with streptococcal toxic shock syndrome may present with fever, hypotension, rash and evidence of organ dysfunctionJAMA,1993.

For management of streptococcal toxic shock syndrome in adults and children, see Initial therapy for complicated Streptococcus pyogenes (group A streptococcus) bloodstream infections.