Fulminant Streptococcal Infection and Sudden Death in a Pregnant Woman: A Case Report

: A case of fulminant streptococcal infection occurring in a 28-year-old pregnant female is reported. She initially developed pharyngitis and high fever during the 33rd week of gestation. This was treated with oral piperacillin for two days with temporary amelioration. Recurrence of high fever, however, was noted shortly thereafter, which was followed by stillbirth of twin babies, and subsequent development of refractory hypotension and demise of the mother. Autopsy revealed presence of numerous cocci and fibrin thrombi in systemic circulation, and this was thought to be the immediate cause of her death. The causative organism was identified as Streptococcus pyogenes, M3, T3, and was found to be producing streptococcal pyrogenic exotoxin A in vitro. The underlying mechanism for this serious infection remains unknown.