Fatal group A streptococcal meningitis and toxic shock-like syndrome: case report.

A previously healthy 8-year-old girl presented with flu-like symptoms, developed toxic shock-like syndrome, and died within 48 hours. At autopsy she was found to have purulent meningitis. The group A beta-hemolytic streptococcus isolated from her CSF was a member of clone ET 2. This strain produced a variant form of streptococcal pyrogenic exotoxin A (SPEA 2) that has recently been associated with widespread toxic shock-like syndrome.