Abstract
Streptococcus pyogenes, also known as group A Streptococcus (GAS), is responsible for various conditions, such as pharyngitis, tonsillitis, necrotizing fasciitis, and streptococcal toxic shock syndrome (STSS). STSS, a rapidly progressing infection involving shock and multi-organ failure, was first reported in Japan in 1992, and since then, the number of cases has been steadily increasing. We herein report an autopsy case of STSS that resulted in sudden death. The patient was a 67-year-old woman who died 100 minutes after walking to the emergency department on her own. This case was characterized by multiple organ failure, septic shock, and a lack of polymorphonuclear leukocyte infiltration in necrotic/infected tissues, which are typical features of STSS. Necrotizing fasciitis of the left lower leg was also identified as a potential cause of STSS in this case. Awareness of this condition is critical, and careful screening and a timely diagnosis are essential to ensure the best possible outcomes for the affected patients. In addition, future vaccination strategies are needed.