Clinical Usefulness of Intravenous Human Immunoglobulins in Invasive Group A Streptococcal Infections: Case Report and Review

The spectrum of invasive Streptococcus pyogenes (group A streptococcus) infections includes bacteremia, toxic shock syndrome, and necrotizing fasciitis or myositis. We report the successful use of intravenous immunoglobulins in conjunction with antibiotics and surgery in a case of necrotizing myositis, toxic shock, and bacteremia. A literature review revealed that three other patients with invasive group A streptococcal infections had been treated with immunoglobulins: one adult patient had toxic shock syndrome, one had necrotizing fasciitis, and one child had septic arthritis. On the basis of this report and the review, we suggest that intravenous immunoglobulins may be useful in the treatment of all forms of invasive group A streptococcal infections associated with toxic shock syndrome.