Abstract
Perinatal fulminant group A streptococcal infections are associated with a particularly dramatic course and often results in a loss of both the patient as well as her conceptus. Such a case in an early stage of pregnancy is reported herein in which treatment was successful. The patient, a 34-year-old woman, was referred from another institution with major complaints of vomiting and a pain in the lower abdomen. Shortly after admission and while urinating, she delivered a fetus with an approximate gestational age of 15 weeks. Immediately, the uterine contents were evacuated but within several hours, she developed septic shock and multiple organ failure, which necessitated the start of intensive care. A vaginal culture yielded group A Streptococcus, leading to a diagnosis of perinatal fulminant group A streptococcal infection. The patient was treated with ampicillin and clindamycin. On day 38 of the infection, she was released without complications. Many reported cases of this infection occur in the late stages of pregnancy and few were successfully rescued. Success in the present case may be explained by the early stage of pregnancy that enabled rapid and complete removal of the uterine contents that constituted the infectious foci and early and immediate administration of intensive care. The possibility of a perinatal fulminant group A streptococcal infection should be considered when one faces septicemia in the field of gynecology and obstetrics.
