Author(s): S Zavala, M Arias, P LeguaJournal Issue: Volume 48: Issue 1: 2018 Format Abstract We present a case of a previously healthy 37-year-old male who developed fever, nausea, vomiting, diarrhoea, and hypovolaemia. Within 5.5 h he presented with tachycardia, tachypnoea, became hypotensive and displayed a diffuse erythematous rash. In the following hours he developed persistent hypotension, acute respiratory distress syndrome, liver failure, kidney failure and disseminated intravascular coagulation. A diagnosis of toxic shock syndrome was made, but despite antibiotic therapy, immunoglobulin administration, and supportive measures, the patient died 50 h after presentation. Streptococcus pyogenes was isolated from blood cultures. PDF https://www.rcpe.ac.uk/sites/default/files/jrcpe_48_1_legua.pdf Journal Keywords: intravenous immunoglobulinmulti-organ failureStreptococcal pyrogenic exotoxin AStreptoccoccus pyogenessuperantigentoxic shock syndrome