Fatal toxic shock syndrome associated with Clostridium sordellii after medical abortion

N Engl J Med. 2005 Dec 1;353(22):2352-60. doi: 10.1056/NEJMoa051620.

Abstract

Endometritis and toxic shock syndrome associated with Clostridium sordellii have previously been reported after childbirth and, in one case, after medical abortion. We describe four deaths due to endometritis and toxic shock syndrome associated with C. sordellii that occurred within one week after medically induced abortions. Clinical findings included tachycardia, hypotension, edema, hemoconcentration, profound leukocytosis, and absence of fever. These cases indicate the need for physician awareness of this syndrome and for further study of its association with medical abortion.

Publication types

  • Case Reports

MeSH terms

  • Abdominal Pain / etiology
  • Abortifacient Agents / adverse effects*
  • Abortion, Induced / adverse effects*
  • Adolescent
  • Adult
  • Clostridium Infections / diagnosis
  • Clostridium Infections / etiology*
  • Clostridium sordellii* / genetics
  • Clostridium sordellii* / isolation & purification
  • Diagnosis, Differential
  • Endometritis / microbiology
  • Fatal Outcome
  • Female
  • Humans
  • Hypotension / etiology
  • Mifepristone / adverse effects*
  • Misoprostol / adverse effects*
  • Polymerase Chain Reaction
  • Pregnancy
  • Pregnancy Trimester, First
  • RNA, Ribosomal, 16S / isolation & purification
  • Shock, Septic / diagnosis
  • Shock, Septic / etiology*
  • Shock, Septic / microbiology
  • Tachycardia / etiology
  • Uterus / microbiology
  • Uterus / pathology
  • Vomiting / etiology

Substances

  • Abortifacient Agents
  • RNA, Ribosomal, 16S
  • Misoprostol
  • Mifepristone