Streptococcal toxic shock syndrome following insertion of an intrauterine device - A case report

Venkataramanasetty, R.; Aburawi, Amal; Phillip, H.

doi:10.1080/13625180903149159

Cited by 3 publications

(3 citation statements)

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“…The risk factors for invasive GAS disease include age greater than 65, chronic cardiac and pulmonary disease, diabetes mellitus, HIV, cancer, corticosteroid use, alcohol abuse, injection drug use and varicella infection; none of which our patient possessed 6. Gynaecological literature suggests that a precursor for Streptcoccus pyogenes associated PID is the mechanical disruption of the mucosal epithelial barrier, which can be seen during postpartum state, after intrauterine device insertion, or after endometrial biopsy 7. Our patient did have a dilation and curettage, although it was thought to be too far out from patients presentation.…”

Section: Discussionmentioning

confidence: 82%

Uncommon cause of pelvic inflammatory disease leading to toxic shock syndrome

et al. 2018

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A 44-year-old Caucasian female with a history of endometriosis is admitted to the intensive care unit due to severe left lower quadrant abdominal pain, nausea and vomiting. With patients’ positive chandelier sign on pelvic examination, leucocytosis, elevated erythrocyte sedimentation rate and elevated C-reactive protein indicated that she had pelvic inflammatory disease (PID). PCR tests were negative for Neisseria gonorrhoeae and Chlamydia trachomatis; however, her blood and urine cultures grew Group A streptococci (GAS) with a negative rapid Streptococcus throat swab and no known exposure to Streptococcus. On further review, patient met criteria for GAS toxic shock syndrome based on diagnostic guidelines. The patient was promptly treated with intravenous antibiotics and supportive care, and she acutely recovered. This case demonstrates a rare cause of PID and an atypical aetiology of severe sepsis. It illuminates the importance of considering PID as a source of infection for undifferentiated bacteraemia.

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Section: Discussionmentioning

confidence: 82%

Uncommon cause of pelvic inflammatory disease leading to toxic shock syndrome

et al. 2018

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“…The patient described by Gisser et al ultimately had two exploratory laparotomies, a bilateral salpingectomy and a total abdominal hysterectomy due to the severity of her infection. Furthermore, Venkataramanasetty et al 18 reported the first case of GAS causing TSS after insertion of a copper IUD, which resulted in an emergent total abdominal hysterectomy with bilateral salpingectomy. Other serious complications after insertion of an IUD have been described as well, including severe adnexitis,19 peritonitis and salphingitis 20.…”

Section: Discussionmentioning

confidence: 99%

Intrauterine device infection causing concomitant streptococcal toxic shock syndrome and pelvic abscess withActinomyces odontolyticusbacteraemia

Noska

2016

BMJ Case Reports

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Intrauterine devices (IUDs) are rarely associated with serious infections. We report an unusual concomitant infection of group A Streptococcus (GAS) causing toxic shock syndrome and pelvic abscess with Actinomyces odontolyticus associated with an IUD in a healthy 50-year-old patient. The IUD was subsequently removed and the patient recovered on the appropriate antibiotics. This case highlights the importance of clinicians' high index of suspicion of an IUD infection and prompt removal of the infected foreign body to obtain source control.

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“…Zusammenfassung In der Literatur sind nur vereinzelt Fälle von STSS bei einliegendem IUP beschrieben (5 veröffentlichte Fälle in den letzten 20 Jahren), ein letaler Ausgang ist dann allerdings häufig 3 4 . Elementar sind daher eine schnelle Diagnose und Therapiestart, um die hohe Mortalität zu reduzieren 3 5 .…”

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