Orogenital contact: a cause of chorioamnionitis?

BACKGROUND

Fusobacterium nucleatum and Capnocytophaga species are common oral pathogens and infrequent causes of systemic infection in patients with compromised immunity or disrupted mucosal integrity. The isolation of both organisms from a clinical specimen suggests an oral source of infection.

CASE

A 23-year-old black woman was admitted at 24 weeks' gestation in preterm labor. She subsequently developed signs of clinical chorioamnionitis, including fever, fetal tachycardia, and uterine tenderness. Bacteriologic studies of the amniotic fluid and subchorionic placental cultures yielded F nucleatum and Capnocytophaga species. On review of the patient's history, a temporal relation was noted between orogenital contact and the onset of clinical infection. Thorough evaluation of the patient, including dental examination, did not reveal an obvious source of infection. However, significant periodontal disease was identified in her partner.

CONCLUSION

The concomitant finding of these two organisms in the patient's amniotic fluid and a history of periodontal disease in her partner suggests that chorioamnionitis may have been due to an ascending infection after orogenital contact.