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Case Reports
. 2015 May;16(2):172-178.
doi: 10.1177/1751143714565855. Epub 2015 Jan 12.

Ante-partum necrotising myometritis due to Streptococcal toxic shock

Sanjay Tarvade  1 , Andrew S Lane  2   3
Affiliations
Case Reports

Ante-partum necrotising myometritis due to Streptococcal toxic shock

Sanjay Tarvade et al. J Intensive Care Soc. 2015 May.

Abstract

Group A streptococcus (GAS) causes severe infections in obstetric patients. A rare complication is rapidly progressive necrotising myometritis. Postpartum necrotising myometritis has been previously described; however, antenatal development of such a condition is extremely rare. We present a patient who developed antenatal necrotising myometritis and toxic shock syndrome (TSS) due to GAS during the first trimester of pregnancy, eventually requiring hysterectomy and bilateral oophorectomy. We discuss the rare complication of ante-partum necrotising myometritis, as well as the antibiotic therapy, and treatment of TSS associated with severe Group A Streptococcal infections.

Keywords: Group A streptococcus; Necrosing myometritis; immunoglobulin; obstetric sepsis; toxic shock.

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Figures

Figure 1.
Figure 1.
Extensive haemorhagic necrosis of the ovaries, fallopian tubes, uterus and cervix.
Figure 2.
Figure 2.
Extensive haemorrhagic necrosis of the uterine wall.
Figure 3.
Figure 3.
(a–d) Pathological specimens of the necrotic tissue showing the microscopic and microvascular abnormalities: (a) Haemorrhage and inflammation within the uterus; (b) haemorrhage and necrosis within the uterus; (c) thrombosis with blood vessels admixed with haemorrhage and necrosis and (d) thrombosed blood vessels with background haemorrhage and necrosis within the ovary.
See this image and copyright information in PMC

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