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Early intravenous immunoglobulin therapy (140\u2009g in two doses) was initiated as an adjunct to antimicrobial, surgical and supportive care for refractory streptococcal toxic shock syndrome. Over the course of a twelve-day intensive care unit stay she made good progress with de-escalation of her vasoactive supportive care and reversal of her organ injuries. She was subsequently discharged to ward-based care. At her three-month follow-up appointment she had significantly reduced neurological deficit. Five months following her presentation to hospital she had returned to full-time work.<\/jats:p>","DOI":"10.1136\/bcr-2020-238472","type":"journal-article","created":{"date-parts":[[2021,3,5]],"date-time":"2021-03-05T13:40:09Z","timestamp":1614951609000},"page":"e238472","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["Early intravenous immunoglobulin therapy for group A \u03b2-haemolytic streptococcal meningitis with toxic shock syndrome"],"prefix":"10.1136","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3942-4324","authenticated-orcid":false,"given":"Derick","family":"Adigbli","sequence":"first","affiliation":[{"name":"Intensive Care Unit, Northern Sydney Local Health District, St Leonards, New South Wales, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Valerie","family":"Rozen","sequence":"additional","affiliation":[{"name":"Haematology, Northern Sydney Local Health District, St Leonards, New South Wales, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Archie","family":"Darbar","sequence":"additional","affiliation":[{"name":"Microbiology, Northern Sydney Local Health District, St Leonards, New South Wales, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pierre","family":"Janin","sequence":"additional","affiliation":[{"name":"Intensive Care Unit, Northern Sydney Local Health District, St Leonards, New South Wales, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2021,3,4]]},"reference":[{"key":"2025082722443477000_14.3.e238472.1","first-page":"213","article-title":"[Pharyngotonsillitis caused by Streptococcus pyogenes: clinical and epidemiological aspects and resistance phenotypes towards macrolides]","volume":"10","author":"Crotti","year":"2002","journal-title":"Infez Med"},{"key":"2025082722443477000_14.3.e238472.2","first-page":"317","article-title":"What is hiding behind bubbles of air? 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