Group A streptococcal toxic shock syndrome associated with pelvic peritonitis following diagnostic hysteroscopy in a healthy woman: a case report and review

Abstract

We describe a case of group A streptococcal toxic shock syndrome (TSS) associated with pelvic peritonitis, occurring after a diagnostic hysteroscopy and curettage in a healthy woman. At laparotomy, performed to rule out bowel perforation, the diagnosis of pelvic inflammatory disease and pelvic peritonitis was confirmed. Her general condition deteriorated postoperatively needing supportive care in the intensive care unit, followed by gradual recovery. Although it is difficult to avoid a laparotomy in most cases following a surgical procedure, it is important to consider the diagnosis of streptococcal TSS associated with pelvic peritonitis from ascending sepsis in rapid onset, severely shocked cases.