Group A streptococcal toxic shock syndrome with severe necrotizing fasciitis following hysterectomy--a case report

Loscar, M.; Schelling, G.; Haller, M.; Polasek, J.; Stoll, C.; Kreimeier, U.; Finsterer, U.; Steitz, H.O.; Baumeister, R.; Kimmig, R.; Grabein, B.; Briegel, J.

Intensive Care Medicine 24(2): 190-193

1998


ISSN/ISBN: 0342-4642
PMID: 9539081
DOI: 10.1007/s001340050545
Accession: 046191658

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Abstract
In the last 10 years an increasing number of cases of group A streptococcal toxic shock syndrome have appeared in various clinical settings. The manifestation of this syndrome includes rapidly progressive multiorgan failure and soft-tissue necrosis. This report presents a case of streptococcal toxic shock syndrome caused by Streptococcus pyogenes with severe necrotizing fasciitis of the abdominal wall following hysterectomy. Aggressive surgical intervention with debridement of all necrotic tissue necessitated resection of the complete abdominal wall (skin, subcutaneous tissue, muscle and peritoneum). The abdominal wall defect was covered with free myocutaneous flaps and split-skin grafts. Optimal treatment, including adequate antibiotic therapy and radical surgical intervention, is an indispensable prerequisite of successful outcome.

Group A streptococcal toxic shock syndrome with severe necrotizing fasciitis following hysterectomy--a case report