# Beta‐Thalassemia Major Complicated by Streptococcal Toxic Shock Syndrome: A Rare Case of Survival and Successful Management

## TL;DR

A child with beta-thalassemia survived a rare and severe streptococcal infection through prompt treatment and intensive care.

## Contribution

This paper presents a rare case of successful management of STSS in a beta-thalassemia patient.

## Key findings

- The patient recovered after receiving antibiotics, immunoglobulin, and supportive care.
- Neck swelling and fluid collection resolved following treatment.
- Early recognition and aggressive intervention were critical for survival.

## Abstract

Beta‐thalassemia is an inherited blood disorder associated with defective hemoglobin production and impaired immunity, increasing susceptibility to severe infections. Streptococcus pyogenes poses a significant risk due to its potential to cause streptococcal toxic shock syndrome (STSS), a life‐threatening condition characterized by fever, shock, and multiorgan failure. We report a rare survival case of a nine‐year‐old child with beta‐thalassemia major who developed STSS secondary to Streptococcus pharyngitis. The patient presented with fever, neck swelling, hematemesis, and hypovolemic shock, requiring urgent resuscitation and intensive care unit admission. Laboratory tests revealed pancytopenia and renal dysfunction, and neck CT showed diffuse lymphadenopathy and fluid collection. A nasal discharge culture confirmed Streptococcus pyogene as the cause. The patient received empirical antibiotics, intravenous immunoglobulin (two doses), and supportive care, leading to clinical recovery. The neck swelling resolved, and ultrasound confirmed no residual fluid collection. This case highlights the critical need for early recognition and aggressive management in beta‐thalassemia patients with severe infections.