• Norifumi Matsuda, Kosuke Ishikawa, Emi Funayama, Shintaro Mitamura, Satoru Sasaki, Yuhei Yamamoto, and Taku Maeda.
• Department of Plastic and Reconstructive Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Hokkaido, Japan.
• J Emerg Med. 2022 Sep 1; 63 (3): e72e76e72-e76.

BackgroundStreptococcal toxic shock syndrome (STSS) is diagnosed based on signs of shock with multiorgan system involvement, a generalized erythematous macular rash, and rapidly progressive and destructive soft tissue infection.Case ReportThe patient was a 2-year-old girl with intramuscular venous malformation in the neck in which an infection occurred, developing into STSS. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: Group A streptococcal infections are common in children and usually have a mild clinical presentation, but may be life threatening in severe cases. Patients with venous malformations are known to have slow-flow anomalies with venous pooling, which can result in hypoxia and possible immune cell dysfunction. Thus, clinicians should be aware of STSS when a patient with venous malformation has a rapidly progressive infection.Copyright © 2022 Elsevier Inc. All rights reserved.

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