Volume 15
Number 0
Jan 2011
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Case Reports
BM van der Oord, C Hol, B Manten1

Streptococcal Toxic shock syndrome (Tss) is caused by an infection with Group A streptococcus (GAs). streptococcal pyrogenic exotoxins type A (sPEA) and/or type B (sPEB) are found in the majority of cases of severe GAs infections and play an im- portant role in virulence. These exotoxins can activate the immune system by bypassing the usual antigen-mediated immune response sequence, resulting in the release of large quantities of inflammatory cytokines. These cytokines cause capillary leak and tissue damage, leading to shock and Multi Organ Failure. Overall mortality is 30 to 80 percent, despite aggressive modern therapy [1,2,3,4]. Even though early symptoms can be vague and unspecific, as in our case, it is important to suspect and diagnose Tss at an early stage, because early treatment may have a beneficial effect on outcome.


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