title: Puerperal group A Streptococcus infection: a case report.
abstract: BACKGROUND
  Group A Streptococcus (GAS) sepsis is a rare event but carries a high risk of maternal mortality.
  
  
  METHODS
  A case of puerperal infection occurred with GAS. This patient had had an uneventful prenatal and intrapartum course. She was noted to have high, spiking fevers immediately postpartum, with minimal clinical symptoms. Her blood cultures were positive for GAS, most likely from a urinary tract infection. She was started on broad-coverage antibiotics and defervesced on postpartum day 4. She remained afebrile and was discharged on postpartum day 8.
  
  
  CONCLUSIONS
  Patients with puerperal GAS sepsis commonly appear well clinically, with minor somatic complaints. GAS bacteremia should be suspected and promptly treated in women with high, spiking fevers early in the postpartum period. There are currently no guidelines on preventing vertical transmission. It is unclear how a patient with a previous history of GAS should be managed. Prophylactic use of penicillin during future labor may be warranted.
authors.affiliation: Departments of Obstetrics and Gynecology, Boston Medical Center, Boston, Massachusetts 02118, USA.
authors.forename: Vivien H
authors.initials: VH
authors.lastname: Lee
authors.forename: Carol
authors.initials: C
authors.lastname: Sulis
authors.forename: Raja A
authors.initials: RA
authors.lastname: Sayegh
mesh_terms: D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D016470:Bacteremia / Q000382:microbiology; D001437:Bacteriuria / Q000382:microbiology; D036861:Delivery, Obstetric; D005260:Female; D005335:Fever of Unknown Origin / Q000209:etiology*; D006801:Humans; D011247:Pregnancy; D011645:Puerperal Infection / Q000188:drug therapy / Q000209:etiology / Q000382:microbiology*; D013290:Streptococcal Infections / Q000150:complications* / Q000188:drug therapy; D013297:Streptococcus pyogenes / Q000302:isolation & purification*; D016896:Treatment Outcome; D014552:Urinary Tract Infections / Q000150:complications
chemical_list: D000900:Anti-Bacterial Agents