| Summary: | We report a fatal case of post-partum streptococcal toxic shock syndrome in a patient who was previously
healthy and had presented to the emergency department with an extensive blistering ecchymotic lesions over her
right buttock and thigh associated with severe pain. The pregnancy had been uncomplicated, and the mode of
delivery had been spontaneous vaginal delivery with an episiotomy. She was found to have septicemic shock
requiring high inotropic support. Subsequently, she was treated for necrotizing fasciitis, complicated by septicemic
shock and multiple organ failures. A consensus was reached for extensive wound debridement to remove
the source of infection; however, this approach was abandoned due to the patient’s hemodynamic instability and
the extremely high risks of surgery. Both the high vaginal swab and blister fluid culture revealed Group A beta
hemolytic streptococcus infection. Intravenous carbapenem in combination with clindamycin was given. Other
strategies attempted for streptococcal toxic removal included continuous veno-venous hemofiltration and administration
of intravenous immunoglobulin. Unfortunately, the patient’s condition worsened, and she succumbed
to death on day 7 of hospitalization.
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