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迟缓爱德华氏菌宫内感染致产妇围产期感染性休克:病例报告及文献复习

Maternal peripartum septic shock caused by intrauterine infection with Edwardsiella tarda: A case report and review of the literature.

作者信息

Miyazawa Yuki, Murakami Keisuke, Kizaki Yuichiro, Itaya Yukiko, Takai Yasushi, Seki Hiroyuki

机构信息

Division of Maternal and Fetal Medicine, Center for Maternal, Fetal and Neonatal Medicine, Saitama Medical Center, Saitama Medical University, Saitama, Japan.

出版信息

J Obstet Gynaecol Res. 2018 Jan;44(1):171-174. doi: 10.1111/jog.13476. Epub 2017 Nov 2.

Abstract

Edwardsiella tarda (E. tarda) is a rare pathogen in humans, especially during the peripartum period. Only a few cases of fatal neonatal infection with E. tarda have been reported. Herein, we describe a case of maternal septicemia caused by E. tarda following peripartum chorioamnionitis. The mother developed septic shock, disseminated intravascular coagulation and a post-cesarean wound hematoma with abscess. Her condition improved with multidisciplinary therapy including blood transfusion, antimicrobial agents, recombinant thrombomodulin and surgical debridement. E. tarda was isolated from the maternal blood, cesarean wound and neonatal skin, pharynx and gastric fluid. This case demonstrates that peripartum infection with E. tarda is a rare but life-threatening condition, not only for the neonate but also for the mother.

摘要

迟缓爱德华氏菌是人类罕见的病原体,尤其是在围产期。仅有少数迟发性爱德华氏菌致新生儿致命感染的病例报道。在此,我们描述了1例围产期绒毛膜羊膜炎后由迟缓爱德华氏菌引起的产妇败血症病例。该母亲发生了感染性休克、弥散性血管内凝血及剖宫产术后伤口血肿伴脓肿形成。通过包括输血、抗菌药物、重组血栓调节蛋白及外科清创术在内的多学科治疗,其病情得到改善。迟缓爱德华氏菌从产妇血液、剖宫产伤口以及新生儿皮肤、咽和胃液中分离出来。该病例表明,围产期迟缓爱德华氏菌感染是一种罕见但危及生命的情况,不仅对新生儿,对母亲也是如此。

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