Necrotizing proctitis caused by Streptococcus pyogenes.

We report the case of a 65-year-old patient with peritonitis, septicaemia and toxic shock syndrome in whom the primary focus of infection was acute purulent proctitis with necrosis. Streptococcus pyogenes serotype T28R28 was isolated from blood culture and peritoneal pus. The patient recovered after a prolonged period of intensive therapy and four abdominal operations including anterior resection of the rectum. We believe this to be the first clinical description of streptococcal necrotizing proctitis.