We experienced four cases of group A streptococcal (GAS) deep tissue infections, including three cases of toxic shock-like syndromes (TSLS). None of them were immunosuppressed, but all of them had antecedent flulike symptoms, injury, or tinea pedis, which was supposed to be the cause of the GAS infection. Test exploration was very important and useful, because we could test the exudate with rapid immunoassay kits for antistreptolysin O (ASO) and Gram stain and promptly decide which antibiotics to use. Test exploration also enabled us to proceed to swift intervention when necrotic soft tissue, lack of bleeding, thrombosed vessels, and white-yellowish exudate were found, thus avoiding amputation.
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