A Case Report of Lethal Invasive Group a Streptococcal Infection in the Puerperium

Introduction

Invasive Group A Streptococcus (iGAS) is a well-recognised infection in the peripartum period associated with high morbidity and mortality [1,2]. In the late 1980’s the maternal mortality rate from sepsis in the UK was 0.4/100 000 maternities, whereas in the period from 2006 to 2008 the maternal mortality rate increased to 1.13/100 000 [3].

Infections with virulent strains of iGAS can take an unpredictable course in which fever or mild somatic symptoms might be the only warning signs before progression to toxic shock syndrome (TSS) in 8-14% of cases [4]. We report a case of uterine infarction secondary to pelvic thrombosis associated with iGAS and TSS treated by intensive care and hysterectomy.

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