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病例报告:产褥期败血症的一种不寻常表现。

Case report: An unusual presentation of puerperal sepsis.

作者信息

Kabiri Doron, Prus Diana, Alter Roie, Gordon Gali, Porat Shay, Ezra Yossef

机构信息

Department of Obstetrics and Gynecology, Hadassah Medical Center, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel.

Department of Pathology, Hadassah Medical Center, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel.

出版信息

Front Med (Lausanne). 2022 Aug 15;9:990731. doi: 10.3389/fmed.2022.990731. eCollection 2022.

Abstract

Group A Streptococcus (GAS; ) is a facultative gram-positive coccus, uncommonly colonizing parturient genitalia, where its presence can potentially lead to a life-threatening invasive infection after delivery. GAS infection typically occurs within the first 4 days post-partum and is characterized by high fever, chills, flashing, abdominal pain, and uterine tenderness. Nonetheless, patients with GAS puerperal sepsis may have an unusual presentation, when fever is absent, and the symptoms and signs can be mild, non-specific, and not indicative of the severity of infection. This unusual presentation may lead to a delayed diagnosis and increase the risk for severe puerperal sepsis. Therefore, in these cases, a high index of suspicion and prompt early antibiotic and surgical treatment is crucial to saving the parturient's life.

摘要

A组链球菌(GAS;)是一种兼性革兰氏阳性球菌,很少定植于产妇生殖器,其存在可能导致分娩后发生危及生命的侵袭性感染。GAS感染通常发生在产后的前4天内,其特征为高热、寒战、恶露、腹痛和子宫压痛。然而,患有GAS产褥期败血症的患者可能有不寻常的表现,即不发热,症状和体征可能轻微、不具特异性,且不表明感染的严重程度。这种不寻常的表现可能导致诊断延迟,并增加严重产褥期败血症的风险。因此,在这些情况下,高度的怀疑指数以及早期及时的抗生素和手术治疗对于挽救产妇生命至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1921/9420856/e21b9240fd1b/fmed-09-990731-g001.jpg

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