Post-partum streptococcal toxic shock syndrome associated with necrotizing fasciitis

Wei, Chuan Chua and Mazlan, Mohd Zulfakar and Ali, Saedah and Che Omar, Sanihah and Wan Hassan, Wan Mohd Nazaruddin and Seevaunnantum, S. Praveena and Mohd Zaini, Rhendra Hardy and Hassan, Mohd Hasyizan and Muhd Besari, Alwi and Abd Rahman, Zaidah and Ayub, Zeti Norfidiyati Salmuna and Abd Ghani, Sabrina and Yaacob, Normalinda and Wan Rosli, Wan Rosilawati (2017) Post-partum streptococcal toxic shock syndrome associated with necrotizing fasciitis. IDCases , 9. pp. 91-94. ISSN 2214-2509

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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.

Item Type: Article
Subjects: R Medicine > RG Gynecology and obstetrics
Divisions: Kampus Kesihatan (Health Campus) > Pusat Pengajian Sains Perubatan (School of Medical Sciences) > Article
Depositing User: Mr Noorazilan Noordin
Date Deposited: 16 Oct 2017 17:17
Last Modified: 16 Oct 2017 17:17

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