CASE REPORT article
Front. Pediatr.
Sec. Pediatric Infectious Diseases
Streptococcal Toxic Shock Syndrome with Acute Respiratory Distress Syndrome Following Adenotonsillectomy in a Child: A Case Report
Provisionally accepted
- Dongguan Children's Hospital, Guangdong Medical University, Dongguan, China
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This article reports a case of an 8-year-old child who developed Streptococcal Toxic Shock Syndrome (STSS) and Acute Respiratory Distress Syndrome (ARDS) following adenotonsillectomy, summarizing the diagnostic and treatment process. Preoperative blood tests, CRP levels, and chest X-rays of the child showed no abnormalities. However, within two hours after surgery, the patient exhibited high-grade fever, dyspnea, and altered mental status, rapidly progressing to shock and ARDS. Although shock was not diagnosed promptly in the early stage, leading to non-standardized fluid resuscitation therapy, blood pressure and heart rate eventually stabilized after adjusting the fluid resuscitation protocol and combining vasoactive medications. The diagnosis of STSS was ultimately confirmed based on sputum bacterial culture from endotracheal intubation and targeted next-generation sequencing(tNGS) results. STSS manifests with sudden onset and rapid progression clinically. It is often misdiagnosed in the early stages, resulting delayed treatment of shock and consequently an extremely high mortality rate.
Keywords: Streptococcus pyogenes, Streptococcal toxic shock syndrome (STSS), Acute respiratory distress syndrome (ARDS), Continuous renal replacement therapy (CRRT), adenotonsillectomy
Received: 01 Oct 2025; Accepted: 14 Nov 2025.
Copyright: © 2025 Yang, Zhijun, Li and Ma. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Wenhai Yang, 2093006021@qq.com
Keze Ma, azema2005@163.com
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