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A case of fulminant group A streptococcal infection occurring in a 6-year-old Japanese child is reported. She was accompanied by massive pulmonary hemorrhage and subsequent asphyxia. She initially had pharyngalgia with fever. The cephalosporin antibiotic was given orally for 3 days. Three days after that recurrence of fever and pharyngalgia was noted. Twelve hours later tachypnea and a sudden onset of hemoptysis was noted. She manifested DOA (dead on arrival) and died in the emergency room. Autopsy revealed the presence of numerous cocci in the vessels and massive pulmonary hemorrhage. Streptococcus pyogenes was isolated from the blood. The serotype of this group A streptococcal organism was typed as M4, T4, which produces exotoxin type B and C, which was sensitive to the penicillins.

Fulmonant Group A Streptococcal Infection Accompanied by Massive Pulmonary Hemorrhage and Subsequent Asphyxia: A Case Report