BMJ Case Reports 2013; doi:10.1136/bcr-2013-009502

Primary group A streptococcal septic shock syndrome simulating perforated appendicitis in a previously healthy girl

  1. Ashok Rajimwale3
  1. 1Department of Paediatric Urology, University College London Hospitals NHS Foundation Trust, London, UK
  2. 2Department of Paediatric Urology, Great Ormond Street Children Hospital NHS Trust, London, UK
  3. 3Department of Paed Surgery, LRI, Leicester, UK
  1. Correspondence to Ramnik V Patel, ramnik{at}


A previously healthy 6-year-old girl that initially presented with presumed viral gastrointestinal infection for a week and later developed catastrophic primary peritonitis and septic shock requiring resuscitation and emergency exploratory laparotomy without any identifiable intra-abdominal cause of the sepsis and the peritoneal exudates grew group A streptococci. Appropriate antibiotic therapy was instituted and she made a complete recovery.

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