Back to Search
Start Over
Invasive Group A streptococcal postpartum endometritis associated with multi-organ infarctions: an uncommon case presentation and literature review.
- Source :
-
Postgraduate medicine [Postgrad Med] 2020 Aug; Vol. 132 (6), pp. 526-531. Date of Electronic Publication: 2020 May 07. - Publication Year :
- 2020
-
Abstract
- Background : Streptococcal Toxic Shock Syndrome (STSS) is a serious condition that can arise from streptococcal postpartum endometritis. It is associated with a substantial increase in mortality rate and can rarely result in multiorgan infarction. Early recognition plays a vital role in patients' outcome. Objective : To report a case of complicated STSS and review the literature for previous case reports of streptococcal postpartum endometritis to determine if STSS diagnostic criteria (published by the Centers for Disease Control and Prevention) were fulfilled. Case presentation : This is a 41-year-old woman who presented 5 days after an uncomplicated vaginal delivery with endometritis complicated by invasive group A β-hemolytic streptococcus (GAS) infection and confirmed toxic shock syndrome. The patient was initially admitted to the critical care unit due to hemodynamic compromise requiring intravenous (IV) fluids, IV antibiotic therapy with penicillin and clindamycin, and IV immunoglobulin therapy. The patient subsequently developed multi-organ infarctions, acute respiratory distress syndrome requiring noninvasive respiratory support, and severe reactive arthritis. Literature review revealed 15 case reports of GAS postpartum endometritis, five met criteria for confirmed STSS. One patient died from severe septic shock leading to cardiopulmonary arrest. Thirteen out of 15 cases of postpartum endometritis occurred after uncomplicated vaginal delivery. Conclusion : STSS is a serious and possibly fatal medical condition that requires early diagnosis and treatment to prevent poor patient outcomes and death. Careful consideration to the patient's postpartum clinical presentation with the implementation of an intradisciplinary approach should be utilized.
- Subjects :
- Adult
Female
Fluid Therapy methods
Humans
Oxygen Inhalation Therapy methods
Respiratory Distress Syndrome diagnosis
Respiratory Distress Syndrome therapy
Shock, Septic microbiology
Shock, Septic physiopathology
Tomography, X-Ray Computed methods
Treatment Outcome
Anti-Bacterial Agents administration & dosage
Anti-Bacterial Agents classification
Arthritis, Reactive etiology
Arthritis, Reactive therapy
Endometritis microbiology
Endometritis physiopathology
Endometritis therapy
Kidney blood supply
Kidney diagnostic imaging
Puerperal Infection microbiology
Puerperal Infection physiopathology
Puerperal Infection therapy
Splenic Infarction diagnostic imaging
Streptococcal Infections etiology
Streptococcal Infections physiopathology
Streptococcal Infections therapy
Streptococcus pyogenes isolation & purification
Subjects
Details
- Language :
- English
- ISSN :
- 1941-9260
- Volume :
- 132
- Issue :
- 6
- Database :
- MEDLINE
- Journal :
- Postgraduate medicine
- Publication Type :
- Academic Journal
- Accession number :
- 32379557
- Full Text :
- https://doi.org/10.1080/00325481.2020.1760031