Streptococcal toxic shock syndrome (STSS) can be defined as a septic shock syndrome resulting from infection with toxin-producing group A streptococci (GAS). STSS can sporadically present as primary peritonitis in previously healthy persons. Signs of STSS are non-specific and patients generally present with flu-like symptoms and can develop a life-threatening toxic shock syndrome in just a few hours. Diagnosis is mainly by a combination of physical examination, laboratory/culture results, and exclusion of surgical causes by means of imaging modalities and/or surgical exploration. GAS remain penicillin-sensitive and most are clindamycin-sensitive. Prompt supportive treatment, possibly together with high-dose intravenous immunoglobulins, is crucial.

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doi.org/10.1016/j.ijid.2009.07.014, hdl.handle.net/1765/21313
International Journal of Infectious Diseases
Erasmus MC: University Medical Center Rotterdam

Tilanus, A. M. R., de Geus, H., Rijnders, B., Dwarkasing, R., van der Hoven, B., & Bakker, J. (2010). Severe group A streptococcal toxic shock syndrome presenting as primary peritonitis: A case report and brief review of the literature. International Journal of Infectious Diseases, 14(SUPPL. 3). doi:10.1016/j.ijid.2009.07.014