Streptococcus Toxic Shock Syndrome Due to Non Haemolytic Streptococcus pyogenes

Abstract

Aim: Describe the detection of an unusual pathogen associated with a common clinical presentation with abrupt worsening.        Case Presentation: We present the case of a 36-year-old Peruvian male who presented to the Emergency Department with a 24-hour history of fever, nausea, vomits and diarrhea. He received intravenous hydration and antibiotics. In the next eight hours he became toxic and developed septic shock. Despite intensive vasopressor therapy and broad-spectrum antibiotics, patient died of multiorganic failure within the first 48 hours. The first blood culture was positive for Streptococcus pluranimalium, but subsequent molecular testing of the strain showed non-beta-haemolytic Streptococcus pyogenes. Discussion: Streptococcus pluranimalium is a gram positive cocci isolated from organ samples of different animals. It has been described few cases of this bacteria causing human infection. We discuss the similarities and differences between the reported cases and our findings. Surprisingly, after using more advanced tests, the isolated strain was identify as a non-beta-haemolytic Streptococcus pyogenes. Conclusion: The detection of uncommon human pathogens in challenging clinical scenarios requires an early and accurate typification.