Group A beta-haemolytic streptococcus septicaemia: the toxic strep syndrome. Report of our cases developing septic shock and multiple organ failure.

During the last two decades, severe group A beta-haemolytic streptococcal infections have been defined as the "toxic strep syndrome", and have been reported not only in immunocompromised or elderly people, but also occasionally in previously healthy patients. We describe 4 patients presenting with the toxic strep syndrome, requiring surgery and intensive care, and briefly review the related literature. Fatigue, localized pain and other nonspecific symptoms were associated with the onset of the disease, followed by septic shock with multiple organ failure. Early diagnosis and surgical intervention, if necessary, are mandatory. Subsequently, appropriate supportive treatment of vital organ dysfunction and penicillin as the antibiotic of choice represent the cornerstones of the management of this syndrome.