Acute abdomen in a young patient: an uncommon and difficult diagnosis of primary Group A streptococcal peritonitis with toxic shock syndrome

Primary peritonitis due to a Streptococcal Group A infection is a rare condition which is challenging to accurately diagnose due to a vast clinical presentation ranging from abdominal pain to septic shock, sometimes complicated by Toxic Shock Syndrome. Prompt blood cultures, supportive treatment, and antibiotic therapy are the mainstay of treatment. Surgical exploration can be necessary in case of clinical deterioration and suspicion of secondary peritonitis. The aim of this article is to address the clinical characteristics, challenges in diagnosis, and management options for this potentially fatal syndrome.