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Group A Streptococcal Toxic Shock in Gynecology



Group A streptococcus (GAS) is a common cause of both pharyngitis and skin and soft-tissue infections. It can also occasionally be the causative agent of overwhelming sepsis in the general medical as well as the obstetric and gynecologic patient population in which it produces a toxic shock syndrome which shares some similarities to staphylococcal toxic shock syndrome. GAS is an uncommon cause of bacteremia and a rare cause of sepsis and shock, accounting for just over 10,000 cases of invasive disease and roughly 1,700 deaths in the United States during 2003 [1]. However, sepsis due to GAS and toxic shock syndrome (TSS) is the most severe form of GAS infection, the latter of which is mediated by toxin releasing group A streptococcus. GAS infections appear to have been a frequent cause of mortality long before the understanding of microbiologic origins of infections. Peurperal sepsis,