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Case Reports in Infectious Diseases
Volume 2016, Article ID 2547645, 3 pages
http://dx.doi.org/10.1155/2016/2547645
Case Report

Refractory Toxic Shock-Like Syndrome from Streptococcus dysgalactiae ssp. equisimilis and Intravenous Immunoglobulin as Salvage Therapy: A Case Series

1Department of Medicine, Mount Sinai Beth Israel, New York, NY 10003, USA
2Department of Pharmacy, Mount Sinai Beth Israel, New York, NY 10003, USA
3Department of Pharmacy, NYU Langone Medical Center, New York, NY 10016, USA
4Department of Medicine, NYU Langone Medical Center, New York, NY 10016, USA
5NYU School of Medicine, New York, NY 10016, USA
6Department of Cardiac Surgery, Mount Sinai Beth Israel, New York, NY 10003, USA

Received 22 May 2016; Revised 6 July 2016; Accepted 21 July 2016

Academic Editor: Antonella Marangoni

Copyright © 2016 Marjan Islam et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Infections from Streptococcus dysgalactiae ssp. equisimilis (SDSE) can cause a wide variety of infections, ranging from mild cellulitis to invasive disease, such as endocarditis and streptococcal toxic shock-like syndrome (TSLS). Despite prompt and appropriate antibiotics, mortality rates associated with shock have remained exceedingly high, prompting the need for adjunctive therapy. IVIG has been proposed as a possible adjunct, given its ability to neutralize a wide variety of superantigens and modulate a dysregulated inflammatory response. We present the first reported cases of successful IVIG therapy for reversing shock in the treatment of SDSE TSLS.