title: Streptococcal toxic shock syndrome due to noninvasive pharyngitis.
abstract: Serious infections due to group A beta-hemolytic streptococcus (GABHS) have been reported with increasing frequency in recent years. We report a case of toxic shock syndrome (TSS) due to GABHS pharyngitis in an otherwise healthy 14-year-old boy. The organism was found to produce toxin A. To our knowledge, this is the second reported case of streptococcal TSS associated with the production of toxin A that is not associated with an invasive disease and the first case associated with a documented rise in the level of antibody to the streptococcal toxin itself. Clinicians must be especially vigilant for this entity in patients who have streptococcal pharyngitis because early recognition and institution of aggressive supportive therapy can be lifesaving.
authors.affiliation: Department of Medicine, Maimonides Medical Center, Brooklyn, New York 11219.
authors.forename: E K
authors.initials: EK
authors.lastname: Chapnick
authors.forename: J D
authors.initials: JD
authors.lastname: Gradon
authors.forename: L I
authors.initials: LI
authors.lastname: Lutwick
authors.forename: J
authors.initials: J
authors.lastname: Kim
authors.forename: M
authors.initials: M
authors.lastname: Levi
authors.forename: M H
authors.initials: MH
authors.lastname: Kim
authors.forename: P M
authors.initials: PM
authors.lastname: Schlievert
mesh_terms: D000293:Adolescent; D001426:Bacterial Proteins; D005098:Exotoxins / Q000096:biosynthesis; D006801:Humans; D008297:Male; D008565:Membrane Proteins; D010612:Pharyngitis / Q000150:complications*; D012772:Shock, Septic / Q000209:etiology*; D013290:Streptococcal Infections / Q000150:complications*; D013297:Streptococcus pyogenes / Q000302:isolation & purification* / Q000378:metabolism
chemical_list: D001426:Bacterial Proteins; D005098:Exotoxins; D008565:Membrane Proteins; C117980:SpeA protein, Streptococcus pyogenes; C027951:erythrogenic toxin