Fatal clostridial sepsis after spontaneous abortion

被引:16
作者
Barrett, JP [1 ]
Whiteside, JL [1 ]
Boardman, LA [1 ]
机构
[1] Brown Univ, Sch Med, Women & Infants Hosp Rhode Isl, Dept Obstet & Gynecol, Providence, RI 02905 USA
关键词
D O I
10.1016/S0029-7844(01)01590-3
中图分类号
R71 [妇产科学];
学科分类号
100211 ;
摘要
BACKGROUND: Although obstetric mortality due to complications of Clostridium perfriugens infection is rare at present, we report a case of fatal clostridial sepsis secondary to a septic spontaneous abortion. CASE: A woman at 6-8 weeks' gestation presented with vaginal bleeding and abdominal pain. Although afebrile, the patient was hypotensive, tachycardic, and tachypneic. Physical examination was remarkable for a 10-weeks'-gestation-size uterus, mild pelvic tenderness, a closed cervix without signs of trauma, and moderate vaginal bleeding. Laboratory studies were consistent with infection, hemolysis, and coagulopathy. Sonography demonstrated echolucencies consistent with gas formation in the endometrial cavity. Despite fluid resuscitation, transfusions, antibiotic therapy, and a dilation and curettage, persistent vaginal bleeding required an emergency hysterectomy. Hypotension ensued, and despite aggressive resuscitation attempts, the patient died. CONCLUSION: Rare cases of fatal sepsis secondary to pelvic infection with Clostridium perfringens continue to occur. Hemolysis, anuria, coagulopathy, and characteristic sonographic findings should heighten suspicion of this potentially fatal infection. (C) 2002 by the American College of Obstetricians and Gynecologists.
引用
收藏
页码:899 / 901
页数:3
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