Introduction
Group A streptococcus (GAS), also known as streptococcus pyogenes, causes mild infections, the most frequently observed ones are pharyngitis and impetigo in addition to necrotizing fasciitis. However, the incidence of GAS infection is increasing according to several studies and their presentation are becoming more severe (1,2). Streptococcal toxic syndrome which is considered as a rare and dramatic manifestation of GAS infection, could be presented as primary peritonitis in previous healthy patient complicated by a septic shock with multiple organ failure (3). So we present a rare case of an unusual acute primary peritonitis due to GAS following vaginal delivery in a previous healthy patient aged of 37-year-old, in order to highlight the importance of an early good diagnostic in addition to the initiation of an adequate therapy on time with the aim to improve the prognosis which is dark most of the times.