Garnache F, Simon M, Goffinet P
Clinique Saint-Joseph, Arlon, Belgique.
J Gynecol Obstet Biol Reprod (Paris). 1997;26(6):617-22.
Primary peritonitis caused by Streptococcus pneumoniae is a rare but serious complication of childbirth. We present here three cases of young women who developed abdominal pain after childbirth. All of the patients had fever with abdominal pain, diarrhea and clinical signs of peritonitis. In two cases a laparotomy was performed to remove pus. Cultures taken were positive for Streptococcus pneumoniae. Culture of vaginal swabs and blood cultures were also positive for the same pathogen. For the third patient, both vaginal swabs and blood cultures were positive for Streptococcus pneumoniae, antibiotic therapy only was administered. Outcome was favorable for all. We discuss the pathogenesis, clinical presentation, management and the usefulness for systematic search "for" Streptococcus pneumoniae in vaginal swabs.
由肺炎链球菌引起的原发性腹膜炎是分娩时一种罕见但严重的并发症。我们在此呈现三例产后出现腹痛的年轻女性病例。所有患者均有发热伴腹痛、腹泻及腹膜炎的临床体征。其中两例患者接受了剖腹手术以清除脓液。所取培养物肺炎链球菌呈阳性。阴道拭子培养及血培养该病原体也呈阳性。对于第三位患者,阴道拭子和血培养肺炎链球菌均呈阳性,仅给予了抗生素治疗。所有患者预后良好。我们讨论了其发病机制、临床表现、治疗及在阴道拭子中系统性检测肺炎链球菌的实用性。