A fatal case of streptococcal toxic shock syndrome due to Streptococcus dysgalactiae subsp. equisimilis possibly caused by an intramuscular injection

Hideharu Hagiya, Shunji Okita, Yasutoshi Kuroe, Hiroyoshi Nojima, Shinkichi Otani, Junichi Sugiyama, Hiromichi Naito, Susumu Kawanishi, Shingo Hagioka, Naoki Morimoto

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6 Citations (Scopus)


An 88-year-old man died of streptococcal toxic shock syndrome due to a group G streptococcus infection that was possibly caused by an intramuscular injection given 30 hours earlier in his right deltoid muscle. The causative pathogen was later identified to be Streptococcus dysgalactiae subsp. equisimilis (stG485). Although providing intramuscular injections is an essential skill of health care workers that is performed daily worldwide, it may constitute a port of entry for pathogens via skin breaches that can cause life-threatening infections. All invasive procedures should be carefully performed, especially when immunologically compromised patients are involved.

Original languageEnglish
Pages (from-to)397-402
Number of pages6
JournalInternal Medicine
Issue number3
Publication statusPublished - Feb 13 2013
Externally publishedYes



  • Equisimilis
  • Group G streptococcus (GGS)
  • Intramuscular injection
  • Sepsis
  • Streptococcal toxic shock syndrome (STSS)
  • Streptococcus dysgalactiae subsp

ASJC Scopus subject areas

  • Internal Medicine

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