Streptococcal toxic shocklike syndrome with necrotizing myositis

Streptococcal toxic shock-like syndrome is caused by group A streptococci a nd characterized by multiorgan failure and soft-tissue necrosis, often in y oung patients with a bland history and at most a minor trauma. Diagnosis is reached through the clinical presentation, imaging methods and positive ba cterial verification. The course is fulminant and in the case of muscle inv olvement, mortality reaches 80-100 %. Therapy consists of immediate fasciot omy and often of debridement of affected soft tissues with high-dose antibi otics in intensive care. Sometimes an unconfirmed diagnosis must be suffici ent to operate. We report the case of a 29-year-old man without an exceptio nal history who was forced to undergo thigh amputation, multiple soft-tissu e debridements, and after a total of 240 erythrocyte concentrates, finally hip joint enucleation.