Wolfe R R, Norwick M L, Bofill J A
Department of Obstetrics and Gynecology, Wright-Patterson USAF Medical Center, WPAFB, Ohio, USA.
Am J Perinatol. 1998;15(11):597-600. doi: 10.1055/s-2007-994076.
Meningitis secondary to beta-hemolytic group B streptococcus is rare and represents less than 1% of cases of adult meningitis. We report the first known case of maternal mortality attributed to beta-hemolytic group B streptococcal meningitis. A 23-year-old African-American woman with a benign prenatal course delivered a viable male infant at term. Labor was complicated by thick meconium for which a saline amnioinfusion was utilized. On postpartum Day 1, the patient complained of right hip pain and a headache. Within 12 hr the patient was comatose with fixed and dilated pupils. Life support measures were discontinued secondary to absence of electrocortical activity. Postmortem examination revealed endomyometritis and fulminant meningitis with gram-positive cocci. Placental histologic sections demonstrated acute chorioamnionitis and bateriological cultures noted beta-hemolytic group B streptococcus. The virulence of beta-hemolytic group B streptococcus in the neonate is well recognized. This case demonstrates that beta-hemolytic group B streptococcus is also a potentially fatal maternal pathogen.
由B族β溶血性链球菌引起的脑膜炎较为罕见,在成人脑膜炎病例中所占比例不到1%。我们报告了首例已知的因B族β溶血性链球菌脑膜炎导致孕产妇死亡的病例。一名23岁的非裔美国女性孕期情况良好,足月分娩出一名存活男婴。分娩过程中因胎粪黏稠而采用了生理盐水羊膜腔灌注。产后第1天,患者主诉右髋疼痛和头痛。12小时内,患者昏迷,瞳孔固定且散大。由于缺乏脑电活动,生命支持措施被终止。尸检发现子宫内膜炎和伴有革兰氏阳性球菌的暴发性脑膜炎。胎盘组织学切片显示急性绒毛膜羊膜炎,细菌培养发现B族β溶血性链球菌。B族β溶血性链球菌对新生儿的致病性已得到充分认识。该病例表明,B族β溶血性链球菌也是一种潜在的致命孕产妇病原体。