Two patients with rapidly developing shock, multisystem organ failure, and destructive soft-tissue infection caused by groups G and C streptococci are described. Both patients died rapidly despite aggressive treatment. The clinical characteristics cannot be distinguished from those of toxic shock—like syndrome, but Streptococcus pyogenes was not recovered. These strains did not produce any previously identified type of streptococcal pyrogenic exotoxins. These findings suggest that toxic shock—like syndrome can be caused not only by group A but also groups G and C streptococci. The causative strains of toxic shock—like syndrome may have something in common with unknown virulent factors for this syndrome.
Arch Intern Med. 1997:157:1891-1894