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She was taken repeatedly by parents to ambulatory services and was told she had a viral illness. On the night of that day, the parents called 911 when she was found to have blue extremities. On arrival to a peripheral hospital, she was febrile and hypotension. Her extremities were blue with poor perfusion. The hypotension was refractory to multiple fluid boluses (90ml/kg of normal saline was given) and also to epinephrine. She developed a short period of cardiac asystole after her intubation, which recovered with 20 seconds of chest compression. Afterward, she was started on three inotropic agents in addition to antibiotics; ceftriaxone, clindamycin and vancomycin. Given her critical condition, she was transferred to the Hospital of Sick children.

Invasive Group A Streptoccoacal Infection, Host Factors and Bacterial Determinants