We report three cases of delivery and postpartum bacteremia due to unusual anaerobic bacteria in healthy young women. Leptotrichia amnionii bacteremia occurred during delivery in two mothers and was associated with fetal distress during labor. Conversely, Sneathia sanguinegens bacteremia occurred postpartum, 2 days after delivery, without consequence for the neonate. CASE REPORTS Case 1.A 36-year-old woman from North Africa who was living in France had a pregnancy without complications. Vaginal delivery was associated with fetal distress during labor (acidosis, abnormal cardiac rhythm, and colored amniotic liquid), and a maternal postpartum fever up to 39°C occurred rapidly 1 h after delivery. Three blood cultures from peripheral veins were obtained after delivery but before any antibiotic administration. Each blood culture consisted of a pair of BACTEC PLUS Aerobic/F and Anaerobic/F culture vials (BD, Meylan, France). After blood cultures were obtained, the patient was treated with intravenous antibiotic therapy. One gram of intravenous amoxicillin was administered three times per day. Within 10 days of antibiotic therapy, the patient had recovered completely. The newborn did not develop postnatal clinical or laboratory evidence of infection despite initial fetal distress during labor.Case 2. A 32-year-old woman from Turkey who was living in France had a pregnancy without complications. Vaginal delivery was as described above for case 1, and a maternal postpartum fever up to 39°C occurred rapidly 1 h after delivery. Three blood cultures from peripheral veins were obtained after delivery but before any antibiotic administration. Each blood culture consisted of a pair of BACTEC PLUS Aerobic/F and Anaerobic/F culture vials. After blood cultures were obtained, the patient was treated with intravenous antibiotic therapy. One gram of intravenous amoxicillin was administered three times per day. However, because of fever relapse, clavulanic acid was added on the third day. On day 6, this patient developed another febrile episode, while her white blood cell count and C-reactive protein levels were normal and additional blood cultures remained negative. Within 10 days of antibiotic therapy, the patient had recovered completely. The newborn did not develop postnatal clinical or laboratory evidence of infection despite initial fetal distress during labor.Case 3. A 21-year-old woman from Turkey who was living in France had a pregnancy without complications. Vaginal delivery was without fetal distress, but the patient presented with fever up to 39°C 2 days after delivery. Three blood cultures from peripheral veins were obtained after delivery but before any antibiotic administration. Each blood culture consisted of a pair of BACTEC PLUS Aerobic/F and Anaerobic/F culture vials. After blood cultures were obtained, the patient was treated intravenously with 1 g of amoxicillin-clavulanic acid three times per day, 500 mg of metronidazole two times per day, and 100 mg of netilmicin two times per day for 4 days, which was then sw...

Mastectomy is considered as the standard therapy for gestational breast cancer. Since radiation therapy is harmful for the fetus, conservative surgery is rarely used during pregnancy. Among 16 patients with gestational breast cancer, 10 and 6 were treated with conservative surgery and mastectomy, respectively. No local recurrences occurred with a median follow-up time of 87 months. Among the 10 patients treated with conservative surgery, 3 chose therapeutic abortion and 7 opted to continue their pregnancy. Concerning these 7 fetuses, there were no congenital anomalies, nor growth restriction. All children were normal physically and neurologically. We concluded that conservative breast surgery may be an alternative to mastectomy in the treatment of gestational breast cancer and is safe for the fetus.

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Intramammary sentinel lymph node excision during breast conservative surgery was performed, in this case report, using a prototype intraoperative gamma probe. In contrast to the four axillary sentinel lymph nodes that were subnormal, the excised intramammary sentinel lymph node was massively invaded by cancer cells. Therefore this finding had profound implication for the staging of the tumor and for treatment selection. This case report illustrates that an efficient intraoperative gamma probe is useful to locate and remove intramammary sentinel lymph node in breast cancer patients treated with breast conservation.