TOXIC SHOCK SYNDROME DUE TO GROUP-C STREPTOCOCCI - A CASE-REPORT

Background: Streptococcal toxic shock-like syndrome is a life-threaten ing illness which is on the increase. In early reports, only group A b eta-hemolytic streptococcus was associated with the disease, but recen t evidence indicates non-A streptococci groups are also involved. Obse rvations. We describe the first reported case of streptococcal toxic s hock-like syndrome caused by a group C strain in Italy. Prior to the d isease, the patient, a 46-year-old man, had been in good health and ha d only a 3-day history of sore throat, low grade fever, vomiting, diar rhea, and myalgia before admission. Initially, diagnosis was based onl y on clinical evidence: shock, multiorgan failure, profound hypothermi a, and no apparent signs of infection. Toxic cardiomyopathy was also p resent. Results: Positive throat swab and blood culture confirmed a '' definite case'' following established criteria. Anamnesis showed a dia gnosis of monoclonal gammopathy. Antibiotic treatment was begun immedi ately on admission of the patient, who was discharged 20 days later in good health. Conclusions. This case illustrates how an early diagnosi s and prompt antibiotic therapy can determine a more favorable outcome .