TOXIC SHOCK SYNDROME-RELATED TO SIMULTANEOUS STAPHYLOCOCCUS-AUREUS EPIGLOTTIC ABSCESS AND GROUP-A STREPTOCOCCAL PHARYNGITIS WITH BACTEREMIA- CASE-REPORT

A case of toxic shock syndrome (TSS) is reported in which both a TSST- 1-producing Staphylococcus aureus strain and a group A beta-hemolytic streptococcal strain (GABHS) were involved. The S. aureus group I stra in was isolated from an epiglottic abscess, and the GABHS strain from tonsils and blood cultures. Acute intubation was needed because of obs truction of the airways by swollen and hyperemic mucous membranes in t he oro- and hypopharynx together with external edema around the neck. Intravenous therapy with penicillin G was instituted initially on acco unt of GABHS cellulitis and bacteremia. The patient's condition deteri orated during this treatment, and improvement did not occur until drai nage and intravenous dicloxacillin therapy was instituted. It is not p ossible in this case to draw any conclusions as to which of the two or ganisms caused the TSS or if they were both involved.