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Undiagnosed cases of fatal Clostridium-associated toxic shock in Californian women of childbearing age.

Abstract：

OBJECTIVE:In 2005, 4 Clostridium sordellii-associated toxic shock fatalities were reported in young Californian women after medical abortions. The true incidence of this rare disease is unknown, and a population-based study has never been performed. Additional clostridia-associated deaths were sought to describe associated clinical characteristics. STUDY DESIGN:Population-based death certificate review and a clinical case definition for clostridial-associated toxic shock identified women with likelihood of dying from a Clostridium infection. Formalin-fixed autopsy tissues underwent immunohistochemical and polymerase chain reaction assays. RESULTS:Thirty-eight women were suspected of having C sordellii-associated death. Five tested positive for Clostridium species: 3 for Clostridium perfringens, 1 for C sordellii, and 1 for both. Deaths occurred after the medical procedures for cervical dysplasia (n = 2), surgical abortion (n = 1), stillborn delivery (n = 1), and term live birth (n = 1). None had a medical abortion. CONCLUSION:C sordellii and C perfringens are associated with undiagnosed catastrophic infectious gynecologic illnesses among women of childbearing age.

journal_name

Am J Obstet Gynecol

journal_title

American journal of obstetrics and gynecology

authors

Ho CS,Bhatnagar J,Cohen AL,Hacker JK,Zane SB,Reagan S,Fischer M,Shieh WJ,Guarner J,Ahmad S,Zaki SR,McDonald LC

doi

10.1016/j.ajog.2009.05.023

subject

Has Abstract

pub_date

2009-11-01 00:00:00

pages

459.e1-7

issue

5

eissn

0002-9378

issn

1097-6868

pii

S0002-9378(09)00531-6

journal_volume

201

pub_type

杂志文章

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