Puerperal streptococcal toxic shock syndrome treated with recombinant human activated protein C and intravenous immunoglobulin.
Group A streptococcal sepsis is an uncommon management challenge and has a potentially fulminate course. We present the case of a 25-year-old woman who, within 24h of spontaneous vaginal delivery at 32 weeks of gestation, developed signs of systemic infection and multi-organ failure requiring admission to the intensive care unit. Recombinant human activated protein C and intravenous immunoglobulin were used; subsequently heparin-induced thrombocytopenia and pulmonary embolus also required treatment.
Al-Rawi
S
S
Shackleton Department of Anaesthesia, Southampton University Hospital NHS Trust, Southampton, UK. sarmeen2@hotmail.com
Woodward
L J
LJ
Knight
J
J
D000328:Adult; D000925:Anticoagulants / Q000009:adverse effects / Q000627:therapeutic use; D001772:Blood Cell Count; D003422:Critical Care; D005260:Female; D006493:Heparin / Q000009:adverse effects / Q000627:therapeutic use; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000627:therapeutic use*; D009102:Multiple Organ Failure / Q000150:complications / Q000628:therapy; D011247:Pregnancy; D011486:Protein C / Q000627:therapeutic use*; D011645:Puerperal Infection / Q000175:diagnosis / Q000188:drug therapy*; D011655:Pulmonary Embolism / Q000188:drug therapy; D011994:Recombinant Proteins / Q000627:therapeutic use; D012129:Respiratory Function Tests; D012772:Shock, Septic / Q000175:diagnosis / Q000188:drug therapy*; D013290:Streptococcal Infections / Q000175:diagnosis / Q000188:drug therapy*; D013921:Thrombocytopenia / Q000139:chemically induced / Q000188:drug therapy
D000925:Anticoagulants; D016756:Immunoglobulins, Intravenous; D011486:Protein C; D011994:Recombinant Proteins; D006493:Heparin