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Streptococcus pyogenes and the Toxic Shock Syndrome

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Institute of Hygiene and Epidemiology; 100 42 Praha 10, Czechoslovakia

Ann Intern Med. 1988;108(5):772. doi:10.7326/0003-4819-108-5-772_2
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To the editor: Willoughby and Greenberg (1) have suggested that Streptococcus pyogenes produces toxins that have biological properties similar to the toxin of the toxic shock syndrome. Indeed, in two recent cases of toxic shock syndrome, Streptococcus pyogenes was the only pathogenic organism isolated (2). I describe the first such case reported in the Chechoslovakian medical literature in 1984 (3).

A 37-year-old woman was hospitalized for advanced peritonitis. Sixteen hours after surgical intervention, she had a severe hypotensive shock reaction. She had all the characteristic symptoms of toxic shock syndrome, except mucous membrane hyperemia. Microbiologic examination of 25 samples taken


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