Group A Streptococcal Endometritis and Toxic Shock causing Septic Pelvic Thrombophlebitis and Septic Pulmonary Emboli.

Abstract

Group A Streptococcus (GAS) in the setting of postpartum endometritis can have severe and life-threatening complications. We report a rare case of septic pulmonary emboli that we surmised to have originated from septic pelvic thrombosis in the setting of GAS toxic shock syndrome (TSS) secondary to postpartum endometritis and intrauterine demise. Although the patient had source control with hysterectomy, she continued to have new septic emboli to the lungs seen on CT scans. CT scan of the pelvis demonstrated several filling defects in the renal and pelvic veins. The patient eventually responded well to anticoagulation in addition to antibiotics, which is similar to cases of Lemierre's syndrome. Additionally, we would like to bring attention to how important radiological findings can be missed if there is lack of interspecialty communication about the patient's clinical situation.

• Authors: Sunny Dharia, Sapan Shah, Meghan Kissinger, Alan Sanders, Gurpreet Singh
• Journal: BMJ case reports (BMJ Case Rep) Vol. 16 Issue 11 (Nov 23 2023) ISSN: 1757-790X [Electronic] England
• PMID: 37996149 (Publication Type: Case Reports, Journal Article)
• Copyright: © BMJ Publishing Group Limited 2023. No commercial re-use. See rights and permissions. Published by BMJ.

Topics

• Female
• Pregnancy
• Humans
• Shock, Septic (complications)
• Endometritis (complications, diagnosis)
• Thrombophlebitis (diagnostic imaging, drug therapy, complications)
• Sepsis (complications)
• Streptococcus pyogenes
• Puerperal Infection
• Soft Tissue Infections (complications)
• Pelvis (diagnostic imaging)