A 13-month-old boy with fever of 9 days of evolution suggestive of viriasis was admitted to the emergency room for edema of the upper limbs and oligoanuria of 12 hours of evolution.
Physical examination revealed poor general health, obtundation, hypotension, tachycardia and tachypnea, along with petechial lesions in the shoulders, back and upper limbs.
Blood tests showed: thrombocytopenia in 60% (13.000mm/mm3); C-reactive protein in 28 mg/dl; coagulopathy with activated partial thromboplastin time in 47 sec (control: 117 30 sec), prothr
Treatment consists of expansion, noradrenaline infusion at 0.2 μg/kg/min, and cefoxime.
Mechanical ventilation and peritoneal dialysis were initiated due to renal failure and ionic changes.
Five hours after admission she developed cardiorespiratory arrest due to ventricular fibrillation refractory to resuscitation measures.
Cultures were negative, except for cutaneous petechiae fluid, where S. pyogenes serotype M1T1 was isolated.
