Abstract
Several reports over the past 15 years describe severe group A streptococcal infections causing septic shock, soft-tissue necrosis, and multiple organ failure; a phenomenon known as streptococcal toxic shock-like syndrome (TSLS). However, primary peritonitis associated with TSLS is rare. We report the case of a 40-year-old man admitted with pain in both thighs, hypotension, and severe abdominal pain. His daughter had been diagnosed with streptococcal pharyngitis 3 days earlier. We performed an emergency laparotomy for peritonitis, and culture of the ascites was positive for group A β-hemolytic streptococcus (GAS). Further serotyping of the isolated GAS strain revealed the T-type 22 and the pyrogenic exotoxin gene, spe-C. The criteria for TSLS were clearly met, including the isolation of GAS from ascites, hypotension, liver failure, renal failure, coagulopathy, myositis, and a generalized erythematous macular rash with desquamation.
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Kanetake, K., Kanetake, K., Hayashi, M. et al. Primary Peritonitis Associated with Streptococcal Toxic Shock-Like Syndrome: Report of a Case. Surg Today 34, 1053–1056 (2004). https://doi.org/10.1007/s00595-004-2863-9
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DOI: https://doi.org/10.1007/s00595-004-2863-9