title: Fatal toxic shock syndrome associated with Clostridium sordellii after medical abortion.
abstract: Endometritis and toxic shock syndrome associated with Clostridium sordellii have previously been reported after childbirth and, in one case, after medical abortion. We describe four deaths due to endometritis and toxic shock syndrome associated with C. sordellii that occurred within one week after medically induced abortions. Clinical findings included tachycardia, hypotension, edema, hemoconcentration, profound leukocytosis, and absence of fever. These cases indicate the need for physician awareness of this syndrome and for further study of its association with medical abortion.
authors.affiliation: Centers for Disease Control and Prevention, Atlanta, USA. mfischer@cdc.gov
authors.forename: Marc
authors.initials: M
authors.lastname: Fischer
authors.forename: Julu
authors.initials: J
authors.lastname: Bhatnagar
authors.forename: Jeannette
authors.initials: J
authors.lastname: Guarner
authors.forename: Sarah
authors.initials: S
authors.lastname: Reagan
authors.forename: Jill K
authors.initials: JK
authors.lastname: Hacker
authors.forename: Sharon H
authors.initials: SH
authors.lastname: Van Meter
authors.forename: Vadims
authors.initials: V
authors.lastname: Poukens
authors.forename: David B
authors.initials: DB
authors.lastname: Whiteman
authors.forename: Anthony
authors.initials: A
authors.lastname: Iton
authors.forename: Michele
authors.initials: M
authors.lastname: Cheung
authors.forename: David E
authors.initials: DE
authors.lastname: Dassey
authors.forename: Wun-Ju
authors.initials: WJ
authors.lastname: Shieh
authors.forename: Sherif R
authors.initials: SR
authors.lastname: Zaki
mesh_terms: D015746:Abdominal Pain / Q000209:etiology; D000019:Abortifacient Agents / Q000009:adverse effects*; D000028:Abortion, Induced / Q000009:adverse effects*; D000293:Adolescent; D000328:Adult; D003015:Clostridium Infections / Q000175:diagnosis / Q000209:etiology*; D047989:Paraclostridium sordellii / Q000235:genetics / Q000302:isolation & purification; D003937:Diagnosis, Differential; D004716:Endometritis / Q000382:microbiology; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D007022:Hypotension / Q000209:etiology; D015735:Mifepristone / Q000009:adverse effects*; D016595:Misoprostol / Q000009:adverse effects*; D016133:Polymerase Chain Reaction; D011247:Pregnancy; D011261:Pregnancy Trimester, First; D012336:RNA, Ribosomal, 16S / Q000302:isolation & purification; D012772:Shock, Septic / Q000175:diagnosis / Q000209:etiology* / Q000382:microbiology; D013610:Tachycardia / Q000209:etiology; D014599:Uterus / Q000382:microbiology / Q000473:pathology; D014839:Vomiting / Q000209:etiology
chemical_list: D000019:Abortifacient Agents; D012336:RNA, Ribosomal, 16S; D016595:Misoprostol; D015735:Mifepristone