Invasive Group A Streptococcus Infection Leading to Toxic Shock Syndrome, Myositis, and Likely Necrotizing Fasciitis in a Patient with Pemphigus Vulgaris

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Invasive group A streptococcal infection has a reported mortality rate of 70% to 100% among individuals with pemphigus vulgaris.
2

A 44-year-old man with pemphigus vulgaris developed toxic shock syndrome, myositis, and probable necrotizing fasciitis during a severe flare.
3

Streptococcus pyogenes was identified in blood cultures, confirming the diagnosis of invasive group A streptococcal infection.
4

The patient received high-dose intravenous penicillin G for six weeks due to the severity of the infection and extensive thromboses.
5

Multidisciplinary care was provided, highlighting the complexities of managing infections in patients with autoimmune conditions.

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