A case of streptococcal toxic shock syndrome clinically presenting with purpura fulminans

Purpura fulminans is a term that describes an acute, often lethal, syndrome of hemorrhagic necrosis of the skin, due to dermal vascular thrombosis associated with vascular collapse and disseminated intravascular coagulation. Although it is seen in several clinical settings, it occurs most commonly in patients with acute, current infection. The causative organisms include meningococci, Gram-negative bacilli, staphylococci, streptococci and rickettsia. We report a case of streptococcal toxic shock syndrome in a 63-year-old female. She presented won irregular-shaped, massive ecchymoses and hemorrhagic bullae with progressive skin necrosis on her left thigh. Streptococcus pyogenes was found from blood culture and bulk, and multiple organ dysfunction occurred.