Wiebe Ellen, Guilbert Edith, Jacot Francis, Shannon Caitlin, Winikoff Beverly
Department of Family Practice, University of British Columbia, Vancouver, British Columbia, Canada.
Obstet Gynecol. 2004 Nov;104(5 Pt 2):1142-4. doi: 10.1097/01.AOG.0000142738.68439.9e.
Clostridia bacteria are infrequent human pathogens. In the obstetric and gynecologic literature, Clostridium sordellii infections have been very rarely reported. This is a case of infection following medical termination of early pregnancy with mifepristone and misoprostol.
A 27-year-old woman presented for termination of pregnancy at 5.5 weeks from her last menstrual period. She received mifepristone 200 mg orally followed by 800 microg vaginal misoprostol. Three days after administration of misoprostol, she complained of dizziness, pelvic pain, and bleeding. The next day, she experienced worsening of symptoms and was hospitalized. She developed pulmonary edema, ascites, and heart failure. Despite supportive measures, antibiotics, and hysterectomy, she died 3 days later. The post mortem examinations indicated that death was caused by shock secondary to C sordellii infection.
The frequency of infection following medical abortion is low. The rapid and fatal course of this infection is similar to other obstetric and gynecologic cases reported in the literature. Although providers should remain vigilant to the possibility of infection following medical abortion, the overall proven safety of medical abortion remains the same.
梭菌属细菌是罕见的人类病原体。在妇产科文献中，索氏梭菌感染的报道极为罕见。这是一例在使用米非司酮和米索前列醇进行早期妊娠药物流产后发生感染的病例。
一名27岁女性因停经5.5周前来终止妊娠。她口服了200毫克米非司酮，随后阴道给予800微克米索前列醇。在使用米索前列醇三天后，她出现头晕、盆腔疼痛和出血症状。第二天，症状加重并住院治疗。她出现了肺水肿、腹水和心力衰竭。尽管采取了支持措施、使用了抗生素并进行了子宫切除术，但她在三天后死亡。尸检表明死亡原因是索氏梭菌感染继发休克。
药物流产后感染的发生率较低。这种感染的快速致命病程与文献中报道的其他妇产科病例相似。尽管医疗人员应始终警惕药物流产后感染的可能性，但药物流产总体已证实的安全性保持不变。
