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孕期败血症的罕见病因:识别流产嗜衣原体感染

An unusual cause of sepsis during pregnancy: recognizing infection with chlamydophila abortus.

作者信息

Walder Gernot, Hotzel Helmut, Brezinka Christoph, Gritsch Walter, Tauber Robert, Würzner Reinhard, Ploner Franz

机构信息

Department of Hygiene and Social Medicine, Medical University of Innsbruck, Innsbruck, Austria, and Department of Anesthesiology, Regional Hospital of Sterzing, Sterzing, Italy.

出版信息

Obstet Gynecol. 2005 Nov;106(5 Pt 2):1215-7. doi: 10.1097/01.AOG.0000161060.69470.9c.

Abstract

BACKGROUND

Chlamydophila abortus (formerly Chlamydia psittaci serovar 1) is a rare but severe cause of gestational septicemia, with particular problems in diagnosis and clinical management.

CASE

A 32-year-old woman in her fourth pregnancy (16th week of gestation) presented with progressive septicemia after extensive contact with abortive material from her goat flock. Treatment with levofloxacin could not prevent abortion. Multiorgan failure requiring catecholamines and artificial ventilation developed in the patient. After the agent was identified by polymerase chain reaction from acute-phase serum, macrolides were administered and yielded clinical improvement. The patient fully recovered. There were no sequelae in the subsequent 6 months.

CONCLUSION

Cp abortus must be considered in gestational septicemia after contact with ruminants. Polymerase chain reaction from acute-phase serum is a quick and easy way to establish the diagnosis. Macrolide antibiotics are still the treatment of choice.

摘要

背景

流产嗜衣原体(以前称为鹦鹉热衣原体血清型1)是妊娠败血症的一种罕见但严重的病因,在诊断和临床管理方面存在特殊问题。

病例

一名32岁女性,第四次怀孕(妊娠16周),在与羊群的流产材料广泛接触后出现进行性败血症。左氧氟沙星治疗未能防止流产。患者出现多器官功能衰竭,需要使用儿茶酚胺和人工通气。通过聚合酶链反应从急性期血清中鉴定出病原体后,给予大环内酯类药物治疗,临床症状改善。患者完全康复。在随后的6个月中没有后遗症。

结论

接触反刍动物后发生妊娠败血症时必须考虑流产嗜衣原体。急性期血清的聚合酶链反应是一种快速简便的诊断方法。大环内酯类抗生素仍然是治疗的首选。

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