Jänisch Stefanie, Germerott Tanja, Bange Franz-Christoph, Schmidt Anke, Debertin Anette Solveig
Institut für Rechtsmedizin der Medizinischen Hochschule Hannover, Hannover.
Arch Kriminol. 2009 Sep-Oct;224(3-4):93-100.
Nowadays, postnatal sepsis caused by group A Streptococcus (Str. pyogenes) is a rare condition. However, the mortality due to this uncommon disease is still high, and it has been described in the literature more frequently in the last few years. The authors present the case of a female newborn who died 15 hours after spontaneous delivery in the 40th week of gestation. Autopsy revealed a lung edema and solid lung parenchyma with normal findings of the other organs on macroscopic examination. Additional bacteriological testing detected Streptococcus pyogenes in the child. Aspiration pneumonia and signs of sepsis were discovered in the histological examination. Three days postpartum, the mother was hospitalized with Streptococcus pyogenes sepsis. Streptococcus pyogenes colonization of the mother's vaginal flora was assumed to be the origin of the infection. The problem in this case was the macromorphological diagnosis of sepsis and pneumonia in the newborn. The importance of microbiological analysis as a matter of routine is emphasized.
如今，由A组链球菌（化脓性链球菌）引起的产后败血症是一种罕见病症。然而，这种罕见疾病导致的死亡率仍然很高，并且在过去几年的文献中对此有更频繁的描述。作者报告了一例女性新生儿病例，该新生儿在妊娠第40周自然分娩后15小时死亡。尸检显示有肺水肿和肺实质实变，其他器官在宏观检查中未见异常。进一步的细菌学检测在患儿体内检测到化脓性链球菌。组织学检查发现有吸入性肺炎和败血症迹象。产后三天，母亲因化脓性链球菌败血症住院。推测母亲阴道菌群中的化脓性链球菌定植是感染源。该病例的问题在于新生儿败血症和肺炎的大体形态学诊断。强调了将微生物学分析作为常规检查的重要性。
