MMWR Morb Mortal Wkly Rep. 2005 Jul 29;54(29):724.
On July 19, 2005, the Food and Drug Administration (FDA) issued a public health advisory regarding the deaths of four women in the United States after medical abortions with Mifeprex (mifepristone, formerly RU-486; Danco Laboratories, New York, New York) and intravaginal misoprostol. Two of these deaths occurred in 2003, one in 2004, and one in 2005. Two of these U.S. cases had clinical illness consistent with toxic shock and had evidence of endometrial infection with Clostridium sordellii, a gram-positive, toxin-forming anaerobic bacteria. In addition, a fatal case of C. sordellii toxic shock syndrome after medical abortion with mifepristone and misoprostol was reported in 2001, in Canada. All three cases of C. sordellii infection were notable for lack of fever, and all had refractory hypotension, multiple effusions, hemoconcentration, and a profound leukocytosis. C. sordellii previously has been described as a cause of pregnancy-associated toxic shock syndrome.
2005年7月19日，美国食品药品监督管理局（FDA）发布了一项公共卫生公告，内容涉及四名美国女性在使用米非司酮（Mifeprex，即米非司酮，原称RU - 486；丹科实验室，纽约州纽约市）和阴道用米索前列醇进行药物流产后死亡的事件。其中两例死亡发生在2003年，一例在2004年，一例在2005年。美国的这两起病例有与中毒性休克相符的临床症状，并有证据表明感染了梭状芽孢杆菌（一种革兰氏阳性、产毒素的厌氧细菌）。此外，2001年在加拿大报告了一例在使用米非司酮和米索前列醇进行药物流产后发生的致命性梭状芽孢杆菌中毒性休克综合征病例。所有三例梭状芽孢杆菌感染病例的显著特点是不发热，均出现难治性低血压、多处积液、血液浓缩和严重的白细胞增多。梭状芽孢杆菌此前已被描述为妊娠相关中毒性休克综合征的病因。
