An apparent resurgence of invasive and life-threatening group A streptococcal infections in young and previously healthy hosts is reported in several countries. We report a case of fatal necrotizing fasciitis and review the spectrum of these clinical syndromes, including the invasive soft tissue infections. This changing pattern of infection could be explained by an increased incidence of some serotypes of group A Streptococcus carrying specific virulence factors, such as pyrogenic exotoxins.