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.