Salmonella typhiand Pregnancy: A Case Report

[摘要] Background: Salmonella typhimay be a cause of significant morbidity and mortality in both themother and fetus. Febrile illness during pregnancy, especially that associated with hemolysis, isassociated with chorioamnionitis, pyelonephritis, or viral syndrome. As such,S. typhishould beconsidered when a patient presents with a fever and hemolysis. We present a case ofS. typhicomplicating pregnancy.Case:A primigravida at 26 weeks gestation presented with persistent spiking temperature andsevere hemolysis. Her presenting signs and symptoms included fever, vomiting, cough, earache,jaundice, dark urine, and anemia. After 4 units of blood, her posttransfusion hematocrit was 29%.Hemolysis was evident on a peripheral blood smear. Total bilirubin was 2.5 mg/dl and directbilirubin was 1.2 mg/dl. Gentamicin and clindamycin were administered empirically. Stool, blood,and urine cultures were obtained. Blood cultures were positive forS. typhi. Antibiotic coverage waschanged to gentamicin and ceftriaxone. She defervesced on the 5th day and had no further problems.A healthy male infant was delivered vaginally at term.Conclusion:Typhoid fever is a serious infection, and special concern arises whenS. typhicomplicatespregnancy. The diagnosis ofS. typhishould be considered in a gravida presenting with feverwith prompt institution of antibiotic therapy. Appropriate cultures are essential for confirming thediagnosis.

[学科分类] 妇产科学