Uncommon cause of pelvic inflammatory disease leading to toxic shock syndrome

Lusby, Heather; Brooks, Aaron; Hamayoun, Eden; Finley, Amanda

doi:10.1136/bcr-2018-224955

Cited by 4 publications

(3 citation statements)

References 11 publications

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“…Саме ці мікроорганізми, за даними звіту Центрів з контролю і профілактики захворювань (Centers for Disease Control and Prevention, CDC) США від 2019 року, належать до 11 серйозних загроз антибіотикорезистентності (АР) [12]. Окрім цього, в літературі зустрічається все більше повідомлень про випадки важких форм ЗЗОМТ (ТОА, пельвіоперитоніт і сепсис), викликаних атиповими патогенами як в імуноскомпрометованих, так і в імунокомпетентних жінок, і навіть у сексуально неактивних дівчатпідлітків [13][14][15][16][17][18][19][20][21][22].…”

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Modern approaches to the choice of antimicrobial agents for pelvic inflammatory diseases: the role of innovative microbiological methods

Бурка

Тутченко²,

Педаченко

et al. 2020

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Pelvic inflammatory diseases (PID) is comprehensive term that includes infectious-inflammatory lesions of the endometrium, fallopian tubes and ovaries. PID is one of the main causes of treatment of reproductive aged women by gynecologists, and the cause of impaired reproductive function, chronic pelvic pain syndrome and ectopic pregnancy in the absence of treatment.This article provides an overview of current clinical guidelines for diagnosis and general treatment approaches of PID. A detailed analysis of modern scientific researches dedicated to the change of the PID’s pathogens structure and the peculiarities of their clinical presentation today. This analysis showed that despite the leading role of sexually transmitted infections, opportunistic flora is of great importance in the pathogenesis of this pathology. Features of the PID’s clinical course include an increase in the recurrence frequency. These features are associated with the growing worldwide phenomenon of antibiotic resistance.Data from the European Antimicrobial Resistance Surveillance Network report at the European Center for Disease Control “Antibiotic Resistance Surveillance 2017” on the resistance prevalence of clinically relevant pathogenic bacteria to the most commonly used antimicrobials. Nonspecific bacterial pathogens of PID in the European region show a fairly high rate of antibiotic resistance. At the same time, the experience of many countries demonstrates the effectiveness of the strategy of antimicrobial stewardship strategy, one of the main principles of which is microbiological research whenever possible when prescribing antibacterial therapy. Thus regardless of whether representative of the opportunistic flora is a direct cause of a severe PID course or secondary due to previous sexually transmitted diseases, its identification and antibiotic susceptibility testing is critical for the effective treatment of PID (especially severe forms) given the prevalence of antibiotic resistance.

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“…ТОА і сепсис, пов'язані зі стрептококом групи А [16]; летальний випадок пельвіоперитоніту і сепсису, спричиненого Streptococcus pneumoniaе [17];…”

Section: фактори ризику і клінічні прояви ззомт в сучасних умовахunclassified

Modern approaches to the choice of antimicrobial agents for pelvic inflammatory diseases: the role of innovative microbiological methods

Бурка

Тутченко²,

Педаченко

et al. 2020

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“…Infection that can lead to septic shock occurs through various routes, such as the respiratory, gastrointestinal, and genitourinary tracts or soft tissue. Severe sepsis associated with pregnancy or pelvic inflammatory disease has been reported [2,3], but it has rarely been associated with adenomyosis. Here, we report on septic shock in a patient with a significant abscess inside cystic adenomyosis after responsive treatment of pelvic inflammatory disease.…”

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confidence: 99%

Septic shock caused by abscess formation inside cystic adenomyosis after responsive treatment of pelvic inflammatory disease

Song,

Lee,

Yang

et al. 2020

Clin. Exp. Obstet. Gynecol.

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Objective: To report on septic shock in a patient with an abscess inside cystic adenomyosis after responsive treatment of pelvic inflammatory disease. Case report: A 51-year-old woman with known cystic adenomyosis was admitted to the hospital due to fever and low abdominal pain. In suspicion of pelvic inflammatory disease, intravenous antibiotics were administered. As her symptoms and sings of inflammation improved, she was discharged from the hospital after five days. However, after completing 14 days of oral antibiotics, her symptoms aggravated with decreased blood pressure. Magnetic resonance imaging indicated abscess formation inside cystic adenomyosis, and total hysterectomy was performed. Postoperatively, she fell into shock condition. Intravenous antibiotics were administered for 11 days and she was discharged from the hospital with no adverse event. Conclusion: Physicians should be aware of the possibility of septic shock caused by abscess formation inside known cystic adenomyosis.

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Complex clinical management of group AStreptococcalpelvic inflammatory disease after bilateral tubal ligation in a small community hospital

2020

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A 43-year-old woman with a history of bilateral tubal ligation and bilateral ovarian cysts presented to our hospital with progressively worsening right lower quadrant pain and abdominal distension. Her exam findings of vaginal discharge and cervical motion tenderness, in combination with her marked leucocytosis, were suggestive of pelvic inflammatory disease (PID). PCR for Chlamydia trachomatis and Neisseria gonorrhoeae was negative, however, our patient’s blood cultures grew group A Streptococcus. This exceptionally severe presentation of PID, in combination with uncommon laboratory findings, led to complex multidisciplinary clinical decision making guided by extensive literature review. Here, we present a rare case of group A Streptococcus PID after bilateral tubal ligation, and highlight the role of a family medicine primary team in the medical and surgical management of a complex case at a community hospital.

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Uncommon cause of pelvic inflammatory disease leading to toxic shock syndrome

Cited by 4 publications

References 11 publications

Modern approaches to the choice of antimicrobial agents for pelvic inflammatory diseases: the role of innovative microbiological methods

Modern approaches to the choice of antimicrobial agents for pelvic inflammatory diseases: the role of innovative microbiological methods

Septic shock caused by abscess formation inside cystic adenomyosis after responsive treatment of pelvic inflammatory disease

Complex clinical management of group AStreptococcalpelvic inflammatory disease after bilateral tubal ligation in a small community hospital

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