# Streptococcal Toxic Shock Syndrome Following Intestinal Obstruction in a Patient With Crohn’s Disease

## TL;DR

A young woman with Crohn's disease developed streptococcal toxic shock syndrome after intestinal obstruction and recovered with timely treatment.

## Contribution

This case highlights the rare occurrence of STSS in immunosuppressed Crohn's patients and emphasizes the need for prompt diagnosis.

## Key findings

- A 24-year-old Crohn's patient on immunosuppressive therapy developed STSS following intestinal obstruction.
- Early multidisciplinary intervention led to full recovery without long-term effects.
- Blood cultures confirmed emm1-positive M1UK Streptococcus pyogenes as the causative agent.

## Abstract

Streptococcal toxic shock syndrome (STSS) is a rare, life-threatening complication of invasive group A streptococcal (iGAS) infections. We report the case of a 24-year-old woman with Crohn's disease receiving immunosuppressive therapy who developed STSS following intestinal obstruction. On day 2, she developed fever, altered mental status, hypoxemia, erythema, and hypotension. Chest CT revealed bilateral pulmonary infiltrates, and blood cultures grew emm1-positive M1UK Streptococcus pyogenes, confirming STSS. Early multidisciplinary intervention resulted in rapid recovery without sequelae. This case emphasizes the importance of considering iGAS-induced STSS in septic shock, especially in immunocompromised patients, and highlights the need for prompt recognition and treatment.