Case report: group B streptococcal bacteremia and sacroiliitis after mid-trimester dilation and evacuation.
Group B streptococcal bacteremia with septic arthritis is a rare complication of second trimester dilation and evacuation, and may cause substantial post-operative morbidity. A 37-year-old gravida 4 para 1-0-2-1 presented with fever and right hip pain on post-operative day 11 from a second trimester dilation and evacuation for fetal trisomy 21. She was initially found to have septic arthritis involving the right sacroiliac joint and group B streptococcal bacteremia. Transesophageal echocardiogram showed a tricuspid valve, vegetation consistent with endocarditis. After prolonged parenteral antibiotic therapy, she developed septic pulmonary emboli that were successfully treated with anticoagulation therapy. Group B streptococcal infection is a potentially serious post-abortion complication that can cause sacroiliitis, endocarditis and septic pulmonary emboli.
McKenna
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T
Department of Obstetrics and Gynecology, Brigham and Women's Hospital, Boston, MA, USA.
O'Brien
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K
D000028:Abortion, Induced / Q000009:adverse effects*; D000328:Adult; D001170:Arthritis, Infectious / Q000209:etiology*; D004697:Endocarditis, Bacterial / Q000209:etiology*; D005260:Female; D006801:Humans; D011247:Pregnancy; D011262:Pregnancy Trimester, Second; D011655:Pulmonary Embolism / Q000382:microbiology; D013290:Streptococcal Infections / Q000209:etiology*; D013292:Streptococcus agalactiae; D014619:Vacuum Curettage / Q000009:adverse effects*