Group A Streptococcal Toxic Shock Syndrome after a Routine Gynecological Procedure

Table 1

The criteria of streptococcal toxic shock syndrome diagnosis [2].

Laboratory criteria
(1) Isolation of group A Streptococcus from a normally sterile site.
Clinical criteria
(2) Hypotension	Systolic blood .
(3) Multiorgan involvement characterized by two or more of the following:
(a) Renal impairment	.; In patients with preexisting renal disease, a greater than twofold elevation over the baseline level.
(b) Coagulopathy	(×10^4/μL) or DIC.
(c) Liver involvement	Alanine aminotransferase, aspartate aminotransferase, or total bilirubin the upper limit of normal for the patient’s age.; In patients with preexisting liver disease, a greater than twofold increase over the baseline level.
(d) Acute respiratory distress syndrome	Defined by acute onset of diffuse pulmonary infiltrates and hypoxemia in the absence of cardiac failure or by evidence of diffuse capillary leak manifested by acute onset of generalized edema or pleural or peritoneal effusions with hypoalbuminemia.
(e) A generalized erythematous macular rash that may desquamate
(f) Soft-tissue necrosis, including necrotizing fasciitis or myositis, or gangrene