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 <i>Streptococcus</i>, 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 <i>Streptococcus pyogenes</i> 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.