Toxic shock syndrome is an acute and febrile illness that rapidly progress to shock and multi-organ failure, and it is caused by toxin-producing strains of Staphylococcus aureus or Streptococcus species. Streptococcal toxic shock syndrome (STSS) is usually caused by group A streptococci, but non-group A STSS is rare. In this study, we describe a case of STSS caused by Streptococcus agalactiae (group B streptococci) in a patient with alcoholic liver cirrhosis. At arrival in our hospital, the patient had a decreased mental status with hemorrhagic bullae on four extremities, and he progressed to a fatal outcome within 4 days in spite of antibiotic treatment. (Ann Clin Microbiol 2014;17:91-94)