Streptococcal myositis (SM), is a very serious condition with a high mortality rate. The port of entry of the infection is often unknown. We present here a case report concerning a 68-year-old patient with fulminant SM preceded by symptoms of an upper respiratory tract infection. Haemolytic streptococci of group A were found in the blood, muscle tissue and throat. The patient survived after massive therapeutic interventions including intensive care with intravenous antibiotics, fasciotomy, plasma exchange, controlled respiratory ventilation and exarticulation through the shoulder. The patient's wife fell ill at the same time with a sore throat and the same type of streptococci (T-type 3) was found in both patients.