Chorioamnionitis caused by Staphylococcus aureus with intact membranes in a term pregnancy: A case of maternal and fetal septic shock

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• 作者：Sumire Sorano ; Maki Goto ; ^{mgotoh2@aih-net.com" class="auth_mail" title="E-mail the corresponding author} ; Sakiko Matsuoka ; Atsushi Tohyama ; Hiroko Yamamoto ; Sumie Nakamura ; Tatsuya Fukami ; Ryoei Matsuoka ; Hiroshi Tsujioka ; Fuyuki Eguchi
• 关键词：Septic shock ; Chorioamnionitis ; Staphylococcus aureus ; Intact membrane
• 刊名：Journal of Infection and Chemotherapy
• 出版年：2016
• 出版时间：April 2016
• 年：2016
• 卷：22
• 期：4
• 页码：261-264
• 全文大小：1227 K

文摘

Chorioamnionitis is usually caused by migration of cervicovaginal flora through the cervical canal in women with ruptured membranes. Common causative pathogens are genital mycoplasmas, anaerobes, enteric gram-negative bacilli, and group B streptococcus. There have been only seven previous reports of chorioamnionitis due to Staphylococcus aureus and their clinical courses are characterized by rapid disease progression and poor prognosis. This case report describes a case of acute chorioamnionitis due to S. aureus, which was successfully managed with immediate cesarean section and postoperative intensive care. A 22-year-old woman presented at 39 weeks' gestation with a fever and acute lower abdominal pain. Fetal heart monitoring showed fetal distress. Immediate cesarean delivery was performed under general anesthesia. A male infant weighing 2450 g was born. He had Apgar scores of 3 and 7 at 1 and 5 min, respectively. He was immediately intubated and admitted to the neonatal intensive care unit. Maternal blood culture, vaginal culture, neonatal nares, and blood and gastric fluid culture all showed methicillin-sensitive S. aureus. Histopathology of the placenta demonstrated focal acute funisitis and acute chorioamnionitis. Interestingly, most of the patients in the previous reports developed chorioamnionitis due to S. aureus despite the presence of intact membranes, as in our case. Bacterial spread in the absence of membrane rupture and the presence of bacteremia suggests hematogenous, rather than ascending, etiology of S. aureus chorioamnionitis.