'Toxic Strep Syndrome' Associated With Group C Streptococcus

To the Editor. — In the June 1988 issue of theARCHIVES, Bartter et al1described a toxic shock-like syndrome in patients with group A streptococcal infections and coined the termtoxic strep syndrome. Since then, there have been numerous articles2-6describing the clinical manifestations and virulence factors of "toxic strep syndrome." We recently treated a patient with a toxic shock-like illness that was associated with a group C streptococcal infection. As far as we know, group C streptococcus has not been associated with the toxic strep syndrome or with the pyrogenic exotoxins thought to cause the syndrome.8 Report of a Case.—— A 41-year-old woman was admitted with hemodynamic shock and necrotizing fasciitis of her right calf. She was confused and had marked metabolic and hematologic abnormalities including a serum urea nitrogen concentration of 32 mg/dL, creatinine concentration of 2.0 mg/dL, an elevated aspartate aminotransferase level that