tetano
Editor, Senior Moderator
BMJ Case Rep
. 2026 Aug 5;19(8):e273752.
doi: 10.1136/bcr-2026-273752.
Fulminant invasive group A streptococcal infection following influenza A during pregnancy resulting in maternal near-miss
Yutaka Iwagoi[SUP] 1 [/SUP], Saori Yoshimura[SUP] 1 [/SUP], Yasuhiro Yamamoto[SUP] 1 [/SUP], Eiji Kondoh[SUP] 2 [/SUP]
Affiliations
Invasive group A streptococcal (iGAS) infection during pregnancy is rare but associated with disproportionately high maternal mortality. Influenza infection has been shown to increase the virulence of Streptococcus pyogenes, and a global resurgence of iGAS has been reported in the post-COVID-19 era.We report a woman in her early 30s at 32 weeks of gestation who developed fulminant iGAS following influenza A infection. Despite antiviral therapy and repeatedly negative rapid antigen tests for group A streptococcus, her condition rapidly deteriorated, resulting in septic shock, acute respiratory distress syndrome and intrauterine fetal death. Intensive multidisciplinary management including emergency delivery, continuous haemodiafiltration and veno-venous extracorporeal membrane oxygenation was required. The patient survived but required right lower limb amputation due to severe ischaemic complications.This case highlights the potential for influenza to precipitate life-threatening iGAS during pregnancy and underscores the need for early recognition when pregnant patients with influenza show unexpected clinical deterioration.
Keywords: Infectious diseases; Influenza; Pregnancy; Shock, Septic.
. 2026 Aug 5;19(8):e273752.
doi: 10.1136/bcr-2026-273752.
Fulminant invasive group A streptococcal infection following influenza A during pregnancy resulting in maternal near-miss
Yutaka Iwagoi[SUP] 1 [/SUP], Saori Yoshimura[SUP] 1 [/SUP], Yasuhiro Yamamoto[SUP] 1 [/SUP], Eiji Kondoh[SUP] 2 [/SUP]
Affiliations
- PMID: 42557005
- DOI: 10.1136/bcr-2026-273752
Invasive group A streptococcal (iGAS) infection during pregnancy is rare but associated with disproportionately high maternal mortality. Influenza infection has been shown to increase the virulence of Streptococcus pyogenes, and a global resurgence of iGAS has been reported in the post-COVID-19 era.We report a woman in her early 30s at 32 weeks of gestation who developed fulminant iGAS following influenza A infection. Despite antiviral therapy and repeatedly negative rapid antigen tests for group A streptococcus, her condition rapidly deteriorated, resulting in septic shock, acute respiratory distress syndrome and intrauterine fetal death. Intensive multidisciplinary management including emergency delivery, continuous haemodiafiltration and veno-venous extracorporeal membrane oxygenation was required. The patient survived but required right lower limb amputation due to severe ischaemic complications.This case highlights the potential for influenza to precipitate life-threatening iGAS during pregnancy and underscores the need for early recognition when pregnant patients with influenza show unexpected clinical deterioration.
Keywords: Infectious diseases; Influenza; Pregnancy; Shock, Septic.