Журнал клинических случаев

Ovarian Vein Thrombosis Complicating Puerperal Group ‘A’ Streptococcal Sepsis

Abstract

Gaboura A, Safty Z, Das A, Gleeson T, Carey B, Honan D and Babu S

Group A Streptococcus (GAS) puerperal sepsis is still one of the significant causes of morbidity and mortality, despite the dramatic advancements in knowledge, prevention, and sepsis treatment since the days of Zimmerman. The incidence of GAS infections is variable. However, it is around 3-4 cases per 100,000 population every year in developed countries. It would be higher in developing countries. GAS Puerperal sepsis is the infection of the genital tract between membranes' rupture and the 42^nd day postpartum, according to the WHO. We present the case of a 36-yearold Para 2, who came with fever and severe abdominal pain three days after vaginal delivery and progressed to septic shock. Differential diagnosis of complex appendicitis or Right Ovarian vessel thrombosis made. A Laparotomy confirmed Right Ovarian Vein Thrombosis, for which a Right Salpingo-Oophorectomy performed. Blood cultures established GAS infection. The woman made an uneventful recovery following aggressive antibiotic therapy and care in the Intensive Care Unit. The baby received antibiotics. She was discharged home on day 11, in good condition. One of the rarest complications of GAS Puerperal Sepsis is Ovarian Vein Thrombosis. Aggressive IV fluids and antibiotics therapy, as well as surgical intervention, is the mainstay of treatment. Multidisciplinary input is important.