Abstract The patient was admitted to our department with major complaints of
fever, swelling of the left thigh, and a cognition disorder. A blood culture yielded type T1, toxin-B-positive group-A streptococcus. Magnetic resonance imaging of the left foot showed
fasciitis. Severe
group-A streptococcal infection was diagnosed, and the administration of
antibiotics, a massive dosage of
gamma-globulin, and a
steroid preparation were prescribed, which resulted in a general improvement in the symptoms and reductions in the swelling of the left foot and the second finger of the left hand without any sequelae. Following discharge from the hospital, however, destruction of the joint of the first toe of the right foot was recognized. A number of cases of post-streptococcal
reactive arthritis (PSRA) have recently been reported, and the pathogenicity of this
arthritis, which is different from that of
rheumatic fever, has been noted. Severe
group-A streptococcal infections, such as the one described here, may develop into erosive
arthritis after the symptoms, that affect several organs, have disappeared. We believe that because it is possible for post-streptococcal
reactive arthritis to develop, one should be aware of this when dealing with all clinical patients who have
streptococcal infections.