Group A Streptococcal Toxic Shock Syndrome Developing inthe Third Trimester of Pregnancy

[摘要] Background:Group A streptococcal (GAS) toxic shock syndrome (TSS) is an uncommon, but life-threateninginfection during pregnancy and should be considered in rapid onset of shock.Most cases described in the literaturehave occurred in the puerperium.We report a case of GAS TSS occurring during the third trimester of pregnancyin a previously healthy woman.Case:A 31-year-old female, who was 34 weeks pregnant, presented with fevers and a prodromal ‘flu-like’illness. She rapidly developed shock and multiorgan failure. Blood cultures revealed GAS bacteremia and thepatientmet criteria for streptococcal TSS.Despite her eventual recovery, her infant died on postpartumday 15 as aconsequence of the mother's TSS.Conclusions:This case is unusual in that there were no identifiable initiating events or source of the streptococcalinfection, and the TSS developed during pregnancy rather than after delivery. Early recognition of GAS infections isimportant given the rapid onset and high morbidity and mortality associated with these infections. This is the firstreported case utilizing intravenous immunoglobulin for GAS TSS in the puerperium.

[学科分类] 妇产科学