Puerperal Group A Streptococcal Infections: A Case Series and Discussion

Lee, Melissa; Busowski, John D.; Akhter, Kauser; Wallace, Mark R.

doi:10.1155/2013/751329

Cited by 10 publications

(14 citation statements)

References 25 publications

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“…In non-pregnant patients, the cause of sepsis is typically Escherichia coli, Staphylococcus aureus, Pneumococcal organism, or Pseudomonas aeruginosa. However, the most common cause of sepsis in pregnancy is GAS [13,14]. Interleukins 4, 5, 10, and 13 produced by CD4-positive T lymphocytes increase in pregnancy [15,16].…”

Section: Discussionmentioning

confidence: 99%

The most common causative bacteria in maternal sepsis-related deaths in Japan were group A Streptococcus: A nationwide survey

Tanaka

Katsuragi

Hasegawa

et al. 2019

Journal of Infection and Chemotherapy

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The present retrospective study provides an in-depth analysis of the maternal sepsis-related deaths reported in Japan, and aims to guide future care regarding maternal sepsis. This is a nationwide, retrospective, descriptive cohort study. Data were retrospectively analyzed on all maternal death cases related to sepsis reported in Japan from 2010 through 2016. A total of 7,347,727 births and 317 maternal deaths were reported during the study period. The cause of maternal death was sepsis in 24 women (7.5%). Causative bacteria were Streptococcus pyogenes (54.2%), Chlamydia psittaci (8.3%), Mycobacterium tuberculosis (8.3%), Escherichia coli (4.2%), Neisseria meningitidis (4.2%), Epstein-Barr virus (4.2%), and unknown (16.6%). In maternal death due to S. pyogenes (13 women), onset periods ware antepartum in 10 women (76.9%) and postpartum in 3 (23.1%); death within 24 h after hospital admission occurred in 7 women (53.8%); and the median time from hospital admission to death was 12 h (6e744 h). The most common causative bacteria in to maternal sepsis-related death were GAS. When encountering severe sepsis during the peripartum period, we recommend considering severe GAS infection and early intervention.

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Section: Discussionmentioning

confidence: 99%

The most common causative bacteria in maternal sepsis-related deaths in Japan were group A Streptococcus: A nationwide survey

Tanaka

Katsuragi

Hasegawa

et al. 2019

Journal of Infection and Chemotherapy

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“…The early diagnosis of these invasive forms is difficult to make on account of the paucity of initial symptoms, thus leading to delayed recognition [6]. Streptococcal A infections complicated by TSS are rare (6%) [3], and occur in most cases (85%) within the first 2 to 3 postpartum days, preponderantly after normal vaginal delivery [3,5,6,10,12].…”

Section: Discussionmentioning

confidence: 99%

“…During pregnancy, the clinical picture is always complicated by early major multi-organ failure [2-6], suggesting an immunity different from that observed in the postpartum [2, 11,12] and only medical interruption of pregnancy and comprehensive intensive care can ensure a favorable outcome. A shorter delay between the onset of infection and surgical treatment is correlated to a lesser degree of morbidity and mortality [3,4,11].…”

Section: Discussionmentioning

confidence: 99%

Toxic Shock Syndrome detected at 21 weeks’ gestation complicating acute chorioamnionitis with intact sac

Gassmann

Koch

Boudier

et al. 2015

Gynécologie Obstétrique & Fertilité

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“…Despite the aggressive modern management with antibiotics and supportive therapy, the mortality rate from streptococcal TSS remains high (30–70%) . Maternal TSS, which usually occurs in the post‐partum period, presents with flu‐like symptoms followed by multiorgan failure and disseminated intravascular coagulation (DIC) . There are few reported cases of GAS TSS occurring during the peripartum period and those reported are associated with extreme maternal and fetal mortality and morbidity .…”

Section: Introductionmentioning

confidence: 99%

Streptococcal toxic shock syndrome occurring in the third trimester of pregnancy: A case report

Irani

McLaren

Savel

et al. 2017

J of Obstet and Gynaecol

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Group A streptococcal (GAS) toxic shock syndrome (TSS) is a rare life-threatening illness. Most reported cases have occurred in the post-partum period. Here, we report a rare case of a primigravid who developed GAS TSS in the third trimester. We also review the potential preventive measures and treatment modalities for this syndrome. A 29-year-old primigravid presented at 36 weeks' gestation with diarrhea, abdominal pain, fever, and fetal bradycardia. She underwent an emergency cesarean section and was subsequently diagnosed with GAS TSS. She had a complicated post-partum course marked by a 3-month hospital stay and major sequelae. Her infant died on post-partum day 4. GAS TSS should be considered in the differential diagnosis of pregnant patients presenting with fever and rapid onset of septic shock. A consideration to treat GAS that is detected incidentally during routine screening for group B streptococcus is suggested.

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Puerperal Group A Streptococcal Infections: A Case Series and Discussion

Cited by 10 publications

References 25 publications

The most common causative bacteria in maternal sepsis-related deaths in Japan were group A Streptococcus: A nationwide survey

The most common causative bacteria in maternal sepsis-related deaths in Japan were group A Streptococcus: A nationwide survey

Toxic Shock Syndrome detected at 21 weeks’ gestation complicating acute chorioamnionitis with intact sac

Streptococcal toxic shock syndrome occurring in the third trimester of pregnancy: A case report

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