title: Endotoxic shock after gamete intrafallopian transfer.
abstract: OBJECTIVE
  To report an extremely rare case of endotoxic shock due to Enterobacter cloacae that occurred after laparoscopy for gamete intrafallopian transfer (GIFT) in a nulligravid woman.
  
  
  METHODS
  Private fertility center in Cape Town, South Africa.
  
  
  METHODS
  Case report.
  
  
  METHODS
  A 34-year-old woman with primary infertility.
  
  
  METHODS
  Routine preparation for GIFT procedure, sonar aspiration to obtain oocytes, followed by GIFT. Endotoxic shock developed within hours after the procedure, followed by admission to the intensive care unit, intravenous antibiotic therapy, mechanical ventilation, and abdominal hysterectomy.
  
  
  METHODS
  Preventing patient mortality and morbidity.
  
  
  RESULTS
  Discharge from the intensive care unit occurred on day 11 after GIFT, which was day 8 after surgery. A MEDLINE search (1980 to 2003) found no previous literature on endotoxic shock associated with assisted reproduction.
  
  
  CONCLUSIONS
  Gram-negative infection with subsequent endotoxic shock after assisted reproductive techniques is extremely rare. As this case report shows, early diagnosis and active management of these cases are mandatory to prevent serious complications and mortality.
authors.affiliation: Department of Obstetrics and Gynecology, Stellenbosch University and Tygerberg Hospital, Tygerberg, South Africa.
authors.forename: Dawie R
authors.initials: DR
authors.lastname: Slabbert
authors.forename: Thinus F
authors.initials: TF
authors.lastname: Kruger
authors.forename: Thomas I
authors.initials: TI
authors.lastname: Siebert
authors.forename: Piers
authors.initials: P
authors.lastname: Stead
mesh_terms: D000328:Adult; D003428:Cross Infection / Q000209:etiology / Q000382:microbiology; D016972:Enterobacter cloacae / Q000302:isolation & purification; D004756:Enterobacteriaceae Infections / Q000209:etiology* / Q000382:microbiology; D005260:Female; D015181:Gamete Intrafallopian Transfer / Q000009:adverse effects*; D006801:Humans; D007044:Hysterectomy / Q000379:methods; D007247:Infertility, Female / Q000628:therapy*; D010535:Laparoscopy / Q000009:adverse effects*; D011247:Pregnancy; D027724:Reproductive Techniques, Assisted / Q000009:adverse effects; D012772:Shock, Septic / Q000209:etiology* / Q000382:microbiology; D016896:Treatment Outcome; D014591:Uterine Diseases / Q000209:etiology* / Q000382:microbiology / Q000601:surgery