Severe sepsis with multi-organ failure is associated with ahigh mortality rate. This case report highlights thechallenges and modalities available in the management of alady with refractory shock and disseminated intravascularcoagulation (DIC) due to toxic shock syndrome (TSS) fromgenital tract sepsis. Early surgical intervention to removethe source of infection, the use of recombinant activatedfactor VII to treat intractable disseminated intravascularcoagulation and intravenous immunoglobulin to neutralisethe circulating exotoxins, have been employed and shown todrastically improve outcomes.