title: Necrotizing cervical and uterine infection in the postpartum period caused by group A streptococcus.
abstract: BACKGROUND
  Group A Streptococcus, once the most common causes of puerperal sepsis, is now a rare cause of postpartum fever.
  
  
  METHODS
  A term 27-year-old woman presented after spontaneous membrane rupture. After an uncomplicated vaginal delivery, she became febrile without a source of infection. Despite two different antibiotic regimens, she remained febrile for 3 days. A computed tomography scan showed a wedge-shaped discontinuity in the anterior uterus suggesting uterine infection with early abscess formation. The patient underwent exploratory laparotomy and hysterectomy, with an uneventful postoperative course. Uterine pathology revealed a necrotizing infection within the uterus and cervix from Group A Streptococcus.
  
  
  CONCLUSIONS
  Puerperal sepsis from Group A Streptococcus can be a cause of necrotizing infection following delivery. Physicians should be aware of the resurgence of this potentially fatal pathogen.
authors.affiliation: Department of Obstetrics and Gynecology, Christiana Care Health System, Newark, Delaware 19713, USA. dcastagnola@christiancare.org
authors.forename: Danielle E
authors.initials: DE
authors.lastname: Castagnola
authors.forename: Matthew K
authors.initials: MK
authors.lastname: Hoffman
authors.forename: John
authors.initials: J
authors.lastname: Carlson
authors.forename: Cynthia
authors.initials: C
authors.lastname: Flynn
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D011645:Puerperal Infection / Q000175:diagnosis* / Q000628:therapy*; D013290:Streptococcal Infections / Q000175:diagnosis* / Q000628:therapy*; D013297:Streptococcus pyogenes; D014591:Uterine Diseases / Q000175:diagnosis / Q000382:microbiology* / Q000628:therapy