The Last Man Standing Medal is awarded for being the last human alive in an Infection game type It is available in all Infection games and variants. It is represented by a gold, eight pointed star a gold/bronze wheel in the middle. When someone gets this medal the announcer will shout "Last man Standing!" to the player that received this medal. However, the player must either die or the time limit for the round that it's awarded in must end in order to be awarded the medal. This medal is rare in medal chests because there have only been two infection playlists, which spanned for only a few days; it is fairly common for custom games, seeing as infection is one of the most played gametypes in custom games.
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