Abstract:
Background: Pregnancy-related infections are the third most common cause of maternal
death worldwide. The aim of this report is to present a case of pregnancy-related infection,
which progressed into refractory septic shock accompanied by purpura fulminans and
multiple organ failure.
Case: A 23-year-old woman in the postpartum period developed fulminant, refractory
septic shock complicated by purpura fulminans and multiple organ failure syndrome (acute
respiratory distress syndrome, acute kidney injury, and encephalopathy). Management included antibacterial therapy, fluid and transfusion therapy, nutritional support, protective
mechanical ventilation, hydrocortisone, a large dose of ascorbic acid, and thiamine. There
were no neurological consequences and all organ functions returned to normal, although
the predicted hospital mortality based on the Sequential Organ Failure Assessment (SOFA)
score was more than 90%.
Conclusions: Septic shock is a significant, yet not completely understood life-threatening
condition, which can be associated with purpura fulminans, multiple organ dysfunction,
disseminated intravascular coagulation, and massive tissue necrosis.