Fatal toxic shock syndrome associated with Clostridium sordellii after medical abortion.
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.
Fischer
Marc
M
Centers for Disease Control and Prevention, Atlanta, USA. mfischer@cdc.gov
Bhatnagar
Julu
J
Guarner
Jeannette
J
Reagan
Sarah
S
Hacker
Jill K
JK
Van Meter
Sharon H
SH
Poukens
Vadims
V
Whiteman
David B
DB
Iton
Anthony
A
Cheung
Michele
M
Dassey
David E
DE
Shieh
Wun-Ju
WJ
Zaki
Sherif R
SR
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
D000019:Abortifacient Agents; D012336:RNA, Ribosomal, 16S; D016595:Misoprostol; D015735:Mifepristone