title: Group A streptococcal toxic shock syndrome after an office endometrial biopsy: a case report.
abstract: BACKGROUND
  Endometrial biopsy is a common office procedure and is relatively free of serious complications.
  
  
  METHODS
  A 43-year-old woman presented with fevers, vaginal bleeding and abdominal pain after an office endometrial biopsy. She was found to have sepsis, shock abdominal tenderness and an erythematous rash. She was managed with intravenous antibiotics and fluid resuscitation. Once stable, she underwent a total abdominal hysterectomy and bilateral salpingo-oophorectomy, with findings of acute pelvic infection. Blood cultures grew group A beta-hemolytic Streptococcus.
  
  
  CONCLUSIONS
  Since the 1980s, an increase in severe infections caused by Streptococcus pyogenes led to the definition of group A streptococcal toxic shock syndrome. This appears to be the first report of streptococcal toxic shock syndrome occurring after an endometrial biopsy.
authors.affiliation: Department of Obstetrics and Gynecology, University of California San Francisco-Fresno Medical Education Program, Fresno, USA.
authors.forename: Susannah
authors.initials: S
authors.lastname: Mourton
authors.forename: William
authors.initials: W
authors.lastname: Rich
mesh_terms: D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001706:Biopsy / Q000009:adverse effects*; D004717:Endometrium / Q000382:microbiology / Q000473:pathology; D005260:Female; D006801:Humans; D007044:Hysterectomy; D010052:Ovariectomy; D012772:Shock, Septic / Q000188:drug therapy / Q000209:etiology* / Q000601:surgery; D013290:Streptococcal Infections / Q000188:drug therapy / Q000209:etiology* / Q000601:surgery; D013297:Streptococcus pyogenes; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents