TOXIC SHOCK-LIKE SYNDROME

Since the mid-1980s increasing numbers of severe group A streptococcal infections (Streptococcus pyogenes) have been reported worldwide. You nger, healthy patients after minor local trauma are most commonly affl icted. The infection is characterized by a rapid course with shock, se psis, multiorgan failure, soft-tissue infection and a high mortality r ate. This special disease has been termed ''streptococcal toxic shock- like syndrome''. The M-proteins, especially types 1 and 3, and the str eptococcal pyrogenic exotoxin A (speA) might play an important role in the pathogenesis of the infection. High dose therapy with antibiotics , monitoring in the intensive care unit and early, aggressive and ofte n multiple debridement of necrotic soft tissue are necessary to save t he patient's life.