Group A Streptococcal Infections and a Toxic Shock–like Syndrome

To the Editor: Stevens et al. (July 6 issue) 1 report their observations of severe group A streptococcal infections from the Rocky Mountain area associated with the production of scarlet fever toxin A. Within the past two years we have had three patients at Walter Reed Army Medical Center who were healthy adults in their mid-30s who presented with life-threatening multisystem illnesses due to group A streptococci. All the patients had acquired their illnesses in the Middle Atlantic region and presented with similar influenza-like symptoms. Two of the patients had a cutaneous source (cellulitis and fasciitis) of infection, whereas the other . . . No extract is available for articles shorter than 400 words.