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孕妇感染:病例报告。

infection in a pregnant woman: a case report.

机构信息

Department of Obstetrics, Qingdao Municipal Hospital, Qingdao, China.

Department of Laboratory Medicine, Qingdao Municipal Hospital, Qingdao, China.

出版信息

Curr Med Res Opin. 2022 Aug;38(8):1439-1442. doi: 10.1080/03007995.2022.2072091. Epub 2022 May 13.

Abstract

BACKGROUND

belongs is a gram-positive anaerobic coccus (GPAC), which can cause bacterial vaginitis. However, only a few studies have reported severe infection of . This study presented the first case of severe infection of during pregnancy. It aimed to help to fill the gap in the literature, find out the factors that accelerate infection and discuss the significance of the GPAC test.

CASE PRESENTATION

A 35-year-old woman was admitted due to unbearable abdominal pain with dilation of the cervical opening at 22+ weeks of gestation. A blood test revealed electrolyte disturbance and hypoproteinemia. A day before admission, the patient developed pain in the lower abdomen accompanied by yellow-green vaginal discharge. Two hours after admission, the patient suddenly presented with hyperpyrexia and chills. Timely and adequate antibiotic and cooling treatments were administered. After 14 h, the patient again developed chills that lasted for approximately 20 min, accompanied by uterine contractions and membrane rupture. After 3 h, she had a miscarriage and rapidly developed septic shock. She was transferred to the intensive care unit for further infection control, shock correction, and circulatory stabilization. The cultures of blood, secretion specimen, and amniotic fluid indicated infection using a matrix-assisted laser desorption/ionization time-of-flight mass spectrometry, an advanced tool for bacterial species identification.

CONCLUSIONS

is an opportunistic pathogen in pregnant women. Poor physical conditions and pregnancy may accelerate disease progression and lead to severe inflammation.

摘要

背景

属于革兰阳性厌氧菌(GPAC),可引起细菌性阴道炎。然而,仅有少数研究报道过严重的感染。本研究报道了首例妊娠期间感染的严重病例。旨在帮助填补文献空白,找出加速感染的因素,并探讨 GPAC 检测的意义。

病例介绍

一名 35 岁女性因 22+ 周妊娠宫颈口扩张伴难以忍受的腹痛入院。血液检查显示电解质紊乱和低蛋白血症。入院前一天,患者出现下腹痛并伴有黄绿脓性阴道分泌物。入院后 2 小时,患者突然高热寒战。及时给予了充分的抗生素和降温治疗。入院 14 小时后,患者再次出现寒战,持续约 20 分钟,伴有子宫收缩和胎膜破裂。3 小时后,她流产并迅速发生感染性休克。她被转至重症监护病房进一步控制感染、纠正休克和稳定循环。使用基质辅助激光解吸电离飞行时间质谱(一种先进的细菌种属鉴定工具)对血液、分泌物和羊水标本进行培养,均提示感染。

结论

在孕妇中是一种机会性病原体。身体状况不佳和妊娠可能会加速疾病进展,导致严重炎症。

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