Chorioamnionitis due to Lactococcus lactis cremoris : A case report

Abstract

Lactococcus lactis cremoris is rarely involved in human pathology. A thirty two-year old pregnant woman with premature rupture of membrane history presented with chorioamnionitis due to L. lactis cremoris. She underwent an emergency caesarian section and was treated with antibiotics including the association of amoxicillin and clavulanic acid. She was completely recovered. This is the first case to our knowledge of chorioamnionitis due to this organism.

Lactococcus lactis cremoris intra-uterine infection: About an uncommon case report

“…Concerning risk factors, some authors have suggested that immunocompromised subjects are more susceptible to the disease; however, we found only 26% of the cases, including ours, with a compromised immune status [4] , [10] , [19] , [21] , [27] , [30] . Although the evidence for increased susceptibility of pregnant women to infection is quite weak, immunological alterations during this period may impair pathogen clearance [31] .…”

“…Therefore, its pathogenic potential is becoming well known by the scientific community. To our knowledge, our case is the second published case of Lactococcus lactis cremoris IUI and the 27th worldwide for other infectious sites [4] , [7] , [8] , [9] , [10] , [11] , [12] , [13] , [14] , [15] , [16] , [17] , [18] , [19] , [20] , [21] , [22] , [23] , [24] , [25] , [26] , [27] , [28] , [29] , [30] , [31] . Indeed, a review of the literature ( Table 1 ) allowed us to find the 26 cases published before ours and allowed us to highlight some of the features of this uncommon infection.…”

“…Among these cases, women accounted for 41% of the global total, including our patient, making a sex ratio of 3:2 [4] , [10] , [16] , [19] , [20] , [22] , [24] , [25] , [28] , [29] . The age varies from 1 year, more exactly 19 months [13] , to 79 years [22] .…”

“…The hospital course was complicated by premature rupture of the membranes followed by the development of fever, chills and deterioration of the fetal heart rate ( FHR ), imposing an urgent extraperitoneal cesarean section for suspected IUI with fetal impact. Bacteriological examination of a placental sample subsequently yielded growth of Lactococcus lactis cremoris which makes it to our knowledge the second case reported to date of an IUI due to this bacterium [4] .…”

“…Regarding pathophysiology, the mode of invasion was most often considered to be hematogenous (88%) as in the seven cases reported of endocarditis [15] , [17] , [20] , [23] , [26] , [29] , [31] , the five cases of nervous system infection [7] , [11] , [12] , [13] , [24] , the five cases of hepatobiliary system infection [8] , [14] , [16] , [22] , [25] , the three cases of pleuropulmonary infection [9] , [18] , [30] , the first case of IUI [4] as well as in the cases of articular infection [28] , ocular infection [19] and septicemia [27] . But it could also occur by loco-regional spread as in the two cases of cervical soft tissue abscesses from a potential oral site infection [10] , [21] .…”