# Rapid Clinical Recovery in Streptococcal Toxic Shock Syndrome With Intravenous Immunoglobulin (IVIG): A Case Report

## TL;DR

A 37-year-old man with severe streptococcal toxic shock syndrome rapidly improved after receiving intravenous immunoglobulin (IVIG), highlighting its potential as a treatment.

## Contribution

This case report demonstrates the rapid clinical benefit of IVIG in a severe STSS case with limited response to standard therapies.

## Key findings

- The patient showed limited improvement with initial antibiotic therapy and intensive care.
- IVIG administration led to rapid clinical recovery after STSS diagnosis.
- The case supports the potential role of IVIG in managing severe STSS.

## Abstract

Streptococcal toxic shock syndrome (STSS) is a rare but life-threatening condition, with an estimated incidence of 1-3 cases per 100,000 population annually and reported mortality rates exceeding 30% and reaching up to 44% in some series. It is characterized by rapid systemic deterioration due to toxin-producing Streptococcus pyogenes. Prompt recognition and escalation of therapy, including the use of adjunctive intravenous immunoglobulin (IVIG), are critical to improving outcomes. We report the case of a previously healthy 37-year-old man who presented with high-grade fever, hypotension, and a widespread erythematous rash. Initial antibiotic therapy targeting skin and soft tissue infection yielded a limited response. Culture from an ulcerated lesion confirmed beta-hemolytic Streptococcus. Despite broad-spectrum antibiotics and intensive care support, the patient continued to deteriorate. A diagnosis of STSS was made, and IVIG was administered with rapid clinical improvement. This case highlights the importance of early diagnosis, multidisciplinary management, and the potential role of IVIG in severe STSS.