Group a Streptococcus causing necrotizing fasciitis and toxic shock syndrome after medical termination of pregnancy

Obstet Gynecol. 2009 Feb;113(2 Pt 2):504-506. doi: 10.1097/AOG.0b013e3181834626.


Background: Group A Streptococcus is an aerobic gram-positive bacteria known to cause cutaneous infections. Invasive infections can lead to toxic shock syndrome with multiorgan failure and mortality rates of 25-48%.

Case: A healthy, young woman developed necrotizing fasciitis, myonecrosis, and toxic shock syndrome after an elective medical termination of pregnancy. This patient had confirmed group A Streptococcus on blood cultures and underwent surgical debridement. After aggressive surgical treatment, below-the-knee amputation, and antibiotic therapy, the patient survived.

Conclusion: This case demonstrates the need for prompt recognition and treatment of necrotizing fasciitis/toxic shock syndrome.

Publication types

  • Case Reports

MeSH terms

  • Abortifacient Agents / therapeutic use
  • Abortion, Induced / adverse effects*
  • Amputation, Surgical
  • Fasciitis, Necrotizing / etiology*
  • Fasciitis, Necrotizing / microbiology
  • Fasciitis, Necrotizing / surgery
  • Female
  • Humans
  • Mifepristone / therapeutic use
  • Misoprostol / therapeutic use
  • Shock, Septic / complications
  • Shock, Septic / etiology*
  • Streptococcal Infections / etiology*
  • Streptococcus pyogenes* / isolation & purification
  • Young Adult


  • Abortifacient Agents
  • Misoprostol
  • Mifepristone