{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T11:35:11Z","timestamp":1786707311396,"version":"build-2736575974"},"reference-count":5,"publisher":"Danish Medical Association","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Ugeskr L\u00e6ger"],"abstract":"<jats:p>Toxic shock syndrome (TSS) caused by group A Streptococcus is uncommon but associated with high mortality. In this case report, a 17-year-old girl with influenza A presented with a rash, hypotension, parapneumonic effusion and multiorgan failure. Group A streptococci were identified in the pleural fluid. This case highlights the importance of early recognition of TSS, since treatment with clindamycin and immunoglobulin may improve the prognosis. As rates of meningococcal disease have decreased, TSS likely causes an increasing proportion of cases of septic shock among children in Denmark.<\/jats:p>","DOI":"10.61409\/v11250897","type":"journal-article","created":{"date-parts":[[2026,8,5]],"date-time":"2026-08-05T09:41:11Z","timestamp":1785922871000},"page":"1-5","source":"Crossref","is-referenced-by-count":0,"title":["Group A streptococcal toxic shock syndrome with influenza A and parapneumonic effusion"],"prefix":"10.61409","author":[{"given":"Jonathan Pommer","family":"Hansen","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rasmus Kolind","family":"Nielsen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Megan","family":"Dale","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne Gr\u00f8nborg","family":"Vedel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ulrikka","family":"Nygaard","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maren Johanne Heilskov","family":"Rytter","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"40208","published-online":{"date-parts":[[2026,8,3]]},"reference":[{"key":"ref0","doi-asserted-by":"publisher","unstructured":"Wilkins AL, Steer AC, Smeesters PR, Curtis N. Toxic shock syndrome - the seven Rs of management and treatment. J Infect. 2017;74(Suppl 1):S147-S152. https:\/\/doi.org\/10.1016\/S0163-4453(17)30206-2","DOI":"10.1016\/S0163-4453(17)30206-2"},{"key":"ref1","doi-asserted-by":"publisher","unstructured":"De Castro REV, Medeiros DNM, Prata-Barbosa A, Magalhaes-Barbosa MC et al. Surviving Sepsis Campaign International Guidelines for the Management of Septic Shock and Sepsis-Associated Organ Dysfunction in Children. Pediatr Crit Care Med. 2020;21(10):924-925. https:\/\/doi.org\/10.1097\/PCC.0000000000002444","DOI":"10.1097\/PCC.0000000000002444"},{"key":"ref2","doi-asserted-by":"publisher","unstructured":"Nygaard U, Hartling UB, Munkstrup C et al. Invasive group A streptococcal infections in children and adolescents in Denmark during 2022-23 compared with 2016-17 to 2021-22: a nationwide, multicentre, population-based cohort study. Lancet Child Adolesc Health. 2024;8(2):112-121. https:\/\/doi.org\/10.1016\/S2352-4642(23)00295-X","DOI":"10.1016\/S2352-4642(23)00295-X"},{"key":"ref3","doi-asserted-by":"publisher","unstructured":"Nanduri SA, Onukwube J, Apostol M et al. Challenges in surveillance for streptococcal toxic shock syndrome: active bacterial core surveillance, United States, 2014-2017. Public Health Rep. 2022;137(4):687-694. https:\/\/doi.org\/10.1177\/00333549211013460","DOI":"10.1177\/00333549211013460"},{"key":"ref4","doi-asserted-by":"publisher","unstructured":"de Gier B, Vlaminckx BJM, van Roon A et al. Risk of household secondary invasive group A streptococcal infections after a prophylaxis policy change. JAMA Netw Open. 2026;9(1):e2553168. https:\/\/doi.org\/10.1001\/jamanetworkopen.2025.53168","DOI":"10.1001\/jamanetworkopen.2025.53168"}],"container-title":["Ugeskrift for L\u00e6ger"],"original-title":[],"deposited":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T11:04:48Z","timestamp":1786705488000},"score":1,"resource":{"primary":{"URL":"https:\/\/ugeskriftet.dk\/videnskab\/V11250897"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,3]]},"references-count":5,"URL":"https:\/\/doi.org\/10.61409\/v11250897","relation":{},"ISSN":["0041-5782","1603-6824"],"issn-type":[{"value":"0041-5782","type":"print"},{"value":"1603-6824","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,3]]}}}