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

Fatal toxic shock syndrome associated with Clostridium sordellii after medical abortion.

Fischer M, Bhatnagar J, Guarner J, Reagan S, Hacker JK, Van Meter SH, Poukens V, Whiteman DB, Iton A, Cheung M, Dassey DE, Shieh WJ, Zaki SR.

Source

Centers for Disease Control and Prevention, Atlanta, USA. mfischer@cdc.gov

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.

Comment in

Medical vs. surgical management of early pregnancy failure. [N Engl J Med. 2005]
Medical vs. surgical management of early pregnancy failure.Shukunami K, Nishijima K, Kotsuji F. N Engl J Med. 2005 Dec 1; 353(22):2403-4; author reply 2403-4.
Fatal infections associated with mifepristone-induced abortion. [N Engl J Med. 2005]
Fatal infections associated with mifepristone-induced abortion.Greene MF. N Engl J Med. 2005 Dec 1; 353(22):2317-8.
Deaths from Clostridium sordellii after medical abortion. [N Engl J Med. 2006]
Deaths from Clostridium sordellii after medical abortion.Zane SB, Berg CJ. N Engl J Med. 2006 Apr 13; 354(15):1645-7; author reply 1645-7.
Deaths from Clostridium sordellii after medical abortion. [N Engl J Med. 2006]
Deaths from Clostridium sordellii after medical abortion.Sicard D. N Engl J Med. 2006 Apr 13; 354(15):1645-7; author reply 1645-7.
Deaths from Clostridium sordellii after medical abortion. [N Engl J Med. 2006]
Deaths from Clostridium sordellii after medical abortion.Baulieu EE. N Engl J Med. 2006 Apr 13; 354(15):1645-7; author reply 1645-7.

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Clostridium sordellii toxic shock syndrome after medical abortion with mifepristone and intravaginal misoprostol--United States and Canada, 2001-2005. [MMWR Morb Mortal Wkly Rep. 2005]
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Cited by 18 PubMed Central articles

Fulminant leukemoid reaction due to postpartum Clostridium sordellii infection. [J Glob Infect Dis. 2012]
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Agrawal P, Garg R. J Glob Infect Dis. 2012 Oct; 4(4):209-11.
Severe Clostridial Pyomyoma following an Abortion Does Not Always Require Surgical Intervention. [Case Rep Obstet Gynecol. 2011]
Severe Clostridial Pyomyoma following an Abortion Does Not Always Require Surgical Intervention.
Stroumsa D, Ben-David E, Hiller N, Hochner-Celnikier D. Case Rep Obstet Gynecol. 2011; 2011:364641. Epub 2011 Sep 11.
Rapid, simultaneous detection of Clostridium sordellii and Clostridium perfringens in archived tissues by a novel PCR-based microsphere assay: diagnostic implications for pregnancy-associated toxic shock syndrome cases. [Infect Dis Obstet Gynecol. 2012]
Rapid, simultaneous detection of Clostridium sordellii and Clostridium perfringens in archived tissues by a novel PCR-based microsphere assay: diagnostic implications for pregnancy-associated toxic shock syndrome cases.
Bhatnagar J, Deleon-Carnes M, Kellar KL, Bandyopadhyay K, Antoniadou ZA, Shieh WJ, Paddock CD, Zaki SR. Infect Dis Obstet Gynecol. 2012; 2012:972845. Epub 2012 Mar 22.

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