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.