TOXIC SHOCK SYNDROME-ASSOCIATED WITH VULVAR NECROTIZING FASCIITIS

Background: Fifty percent of toxic shock syndrome is associated with n onmenstrual etiologies such as postoperative wound infection. Case: A 44-year-old woman developed necrotizing vulvar fasciitis that was succ essfully treated with surgical debridement and broad-spectrum antibiot ics. However, after improving for 3 days postoperatively, she develope d fever, a generalized maculopapular rash, and renal and liver abnorma lities. As her condition worsened, she developed hypotension and respi ratory distress. After 5 days in the intensive care unit, she graduall y improved. Her wound culture from admission grew multiple organisms, including Staphylococcus aureus that produced toxic shock syndrome tox in-1. Conclusion: Toxic shock may occur in varied gynecologic settings , including pelvic and perineal infection. Successful management requi res a prompt and aggressive response to multi-organ system failure.