Sebri Hajer, Halouani Ahmed, Masmoudi Yassine, Aloui Haithem, Triki Amel, Amor Anissa Ben
Department of obstetrics and gynecology, University Hospital Mongi Slim La Marsa, Tunis, Tunisia.
Department of obstetrics and gynecology, University Hospital Mongi Slim La Marsa, Tunis, Tunisia.
Int J Surg Case Rep. 2023 Nov;112:108909. doi: 10.1016/j.ijscr.2023.108909. Epub 2023 Oct 9.
Infection with the human immunodeficiency virus (HIV) targets immune cells and exposes infected patients to several diseases. For these reasons, HIV infection should be suspected in each situation where post-operative sepsis occurs, to afford therapy and improve the patient's prognosis.
We present a case of a pregnant woman at 39 weeks of gestation who missed her prenatal follow-up. She underwent an emergency caesarian section for severe abnormality in the fetal heart rate. The caesarian section was complicated by a post-partum hemorrhage (PPH). PPH was managed with uterine artery ligation and B-Lynch modified sutures.
Postoperatively, there was the succession of the following events: purulent uterine necrosis, peritonitis, and encephalitis leading to a life-saving hysterectomy. Due to the worsening of the septic condition, HIV screening was performed, after obtaining the patient's consent, and came back positive.
The aim of this case report is to push practicians to think about HIV infection when necessary because missing the diagnosis can seriously threaten patients' health.
人类免疫缺陷病毒（HIV）感染以免疫细胞为目标，使感染患者易患多种疾病。因此，在术后发生败血症的每种情况下都应怀疑HIV感染，以便进行治疗并改善患者的预后。
我们报告一例妊娠39周的孕妇，她未进行产前检查。因胎儿心率严重异常，她接受了急诊剖宫产。剖宫产术后并发产后出血（PPH）。采用子宫动脉结扎和B-Lynch改良缝合法处理PPH。
术后，相继发生了以下情况：脓性子宫坏死、腹膜炎和脑炎，最终进行了挽救生命的子宫切除术。由于败血症病情恶化，在获得患者同意后进行了HIV筛查，结果呈阳性。
本病例报告的目的是促使从业者在必要时考虑HIV感染，因为漏诊会严重威胁患者健康。
