GROUP-A STREPTOCOCCAL TOXIC-SHOCK-SYNDROME WITH SEVERE NECROTIZING FASCIITIS FOLLOWING HYSTERECTOMY - A CASE-REPORT

In the last 10 years an increasing number of cases of group A streptoc occal toxic shock syndrome have appeared in various clinical settings. The manifestation of this syndrome includes rapidly progressive multi organ failure and soft-tissue necrosis. This report presents a case of streptococcal toxic shock syndrome caused by Streptococcus pyogenes w ith severe necrotizing fasciitis of the abdominal wall following hyste rectomy. Aggressive surgical intervention with debridement of all necr otic tissue necessitated resection of the complete abdominal wall (ski n, subcutaneous tissue, muscle and peritoneum). The abdominal wall def ect was covered with free myocutaneous flaps and split-skin grafts. Op timal treatment, including adequate antibiotic therapy and radical sur gical intervention, is an indispensable prerequisite of successful out come.