Sneathia amnii and Maternal Chorioamnionitis and Stillbirth, Mozambique

Abstract

We report a case of Sneathia amnii as the causative agent of maternal chorioamnionitis and congenital pneumonia resulting in a late fetal death in Mozambique, with strong supportive postmortem molecular and histopathologic confirmation. This rare, fastidious gram-negative coccobacillus has been reported to infrequently cause abortions, stillbirths, and neonatal infections.

Keywords: Mozambique; Sneathia amnii; bacteria; chorioamnionitis; gram-negative infection; stillbirth.

Figure

Histologic evidence of amniotic fluid aspiration, bronchopneumonia, and intraalveolar gram-negative coccobacilli in the lung of a stillborn infant, Mozambique. A) Hematoxylin and eosin stain of lung tissue showing acute inflammation within alveoli (bronchopneumonia, upper arrow) and moderate numbers of aspirated squames (lower arrow), consistent with intrauterine fetal distress and associated aspiration of amniotic fluid. Original magnification ×20. B) Higher magnification of panel A tissue showing acute inflammation within alveoli (bronchopneumonia) and a clump of aspirated squames. Original magnification ×40. C) Gram stain of lung showing multiple small, gram-negative coccobacilli mixed with acute inflammation within alveoli (arrows indicate regions with bacteria). Original magnification ×63. D) Polybacterial immunohistochemical assay of lung tissue targeting multiple bacteria highlights the coccobacilli within alveoli (top and bottom arrows). Aspirated squames are also present (middle arrow). Original magnification ×63.