Background: Endometrial biopsy is a common office procedure and is relatively free of serious complications.
Case: A 43-year-old woman presented with fevers, vaginal bleeding and abdominal pain after an office endometrial biopsy. She was found to have sepsis, shock abdominal tenderness and an erythematous rash. She was managed with intravenous antibiotics and fluid resuscitation. Once stable, she underwent a total abdominal hysterectomy and bilateral salpingo-oophorectomy, with findings of acute pelvic infection. Blood cultures grew group A beta-hemolytic Streptococcus.
Conclusion: Since the 1980s, an increase in severe infections caused by Streptococcus pyogenes led to the definition of group A streptococcal toxic shock syndrome. This appears to be the first report of streptococcal toxic shock syndrome occurring after an endometrial biopsy.