Introduction. Infectious diseases caused by Streptococcus pyogenes, a member
of the group A Streptococci (GAS) are among the most common life threatening
ones. Patients with GAS infections have a poor survival rate. Cellulitis is a
severe invasive GAS infection and the most common clinical presentation of
the disease associated with more deaths than it can be seen in other GAS
infections. According to the literature data, most cases of GAS toxic shock
syndrome are developed in the puerperium. However, there are two main
problems with GAS infection in early puerperium and this case report is aimed
at reminding on them. The first problem is an absence of awareness that it
can be postpartal invasive GAS infection before the microbiology laboratory
confirms it, and the second one is that we have little knowledge about GAS
infection, in general. Case report. A 32- year-old healthy woman, gravida 1,
para 1, was hospitalized three days after vaginal delivery with a 38-hour
history of fever, pain in the left leg (under the knee), and head injury
after short period of conscious lost. Clinical picture of GAS infection was
cellulites. Group A Streptoccocus pyogenes was isolated in vaginal culture.
Rapid antibiotic and supportive treatment stopped development of
streptococcal toxic shock syndrome (STSS) and potential multiorganic failure.
Signs and symptoms of the infection lasted 25 days, and complete recovery of
the patient almost 50 days. Conclusion. In all women in childbed with a
history of fever early after delivery, vaginal and cervical culture specimens
should be taken as soon as possible. Early recognition of GAS infection in
early puerperium and prompt initiation of antimicrobial drug and supportive
therapy can prevent development of STSS and lethal outcome.
Fulminant Puerperal Sepsis caused by Hemolytic Group A Streptococci and Toxic Shock Syndrome – A Case Report and Review of the Literature
