Publication date: Aug 05, 2026
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.
Semantics
| Type | Source | Name |
|---|---|---|
| disease | MESH | group A streptococcal infection |
| pathway | KEGG | Influenza A |
| disease | MESH | infection |
| pathway | REACTOME | Influenza Infection |
| disease | MESH | COVID-19 |
| disease | MESH | septic shock |
| disease | MESH | acute respiratory distress syndrome |
| disease | MESH | fetal death |
| disease | MESH | emergency |
| disease | MESH | influenza |
| disease | MESH | clinical deterioration |
| disease | MESH | Infectious diseases |
| drug | DRUGBANK | Influenza A virus |
| disease | MESH | Pregnancy Complications Infectious |