卵巢静脉血栓形成合并产褥期组;链球菌脓毒症

A. Gaboura, Z. Safty, A. Das, T. Gleeson, B. Carey, D. Honan, S. Babu
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摘要

A群链球菌(GAS)产褥期脓毒症仍然是发病率和死亡率的重要原因之一,尽管自齐默尔曼时代以来,在知识、预防和脓毒症治疗方面取得了巨大进步。GAS感染的发生率是可变的。然而,在发达国家,每年每10万人中约有3-4例病例。在发展中国家会更高。根据世界卫生组织的说法,产后败血症是指在胎膜破裂至产后42天之间发生的生殖道感染。我们提出的情况下,36岁Para 2,谁来发烧和严重腹痛阴道分娩后三天,并进展为感染性休克。复杂阑尾炎或右卵巢血管血栓的鉴别诊断。剖腹手术证实右卵巢静脉血栓形成,因此行右输卵管-卵巢切除术。血培养证实GAS感染。在重症监护室接受积极的抗生素治疗和护理后,该妇女顺利康复。婴儿接受了抗生素治疗。第11天,她出院回家,身体状况良好。产后脓毒症最罕见的并发症之一是卵巢静脉血栓形成。积极的静脉输液和抗生素治疗以及手术干预是治疗的主要手段。多学科的投入是重要的。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Ovarian Vein Thrombosis Complicating Puerperal Group andlsquo;Aandrsquo; Streptococcal Sepsis
Group A Streptococcus (GAS) puerperal sepsis is still one of the significant causes of morbidity and mortality, despite the dramatic advancements in knowledge, prevention, and sepsis treatment since the days of Zimmerman. The incidence of GAS infections is variable. However, it is around 3-4 cases per 100,000 population every year in developed countries. It would be higher in developing countries. GAS Puerperal sepsis is the infection of the genital tract between membranes' rupture and the 42nd day postpartum, according to the WHO. We present the case of a 36-yearold Para 2, who came with fever and severe abdominal pain three days after vaginal delivery and progressed to septic shock. Differential diagnosis of complex appendicitis or Right Ovarian vessel thrombosis made. A Laparotomy confirmed Right Ovarian Vein Thrombosis, for which a Right Salpingo-Oophorectomy performed. Blood cultures established GAS infection. The woman made an uneventful recovery following aggressive antibiotic therapy and care in the Intensive Care Unit. The baby received antibiotics. She was discharged home on day 11, in good condition. One of the rarest complications of GAS Puerperal Sepsis is Ovarian Vein Thrombosis. Aggressive IV fluids and antibiotics therapy, as well as surgical intervention, is the mainstay of treatment. Multidisciplinary input is important.
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