1. Undiagnosed cases of fatal Clostridium-associated toxic shock in Californian women of childbearing age
- Author
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Jill K. Hacker, Julu Bhatnagar, Jeannette Guarner, Sherif R. Zaki, Shabbir Ahmad, L. Clifford McDonald, Suzanne B. Zane, Adam L. Cohen, Marc Fischer, Christine S. Ho, Wun-Ju Shieh, and Sarah Reagan
- Subjects
Adult ,medicine.medical_specialty ,medicine.medical_treatment ,Population ,Clostridium sordellii ,Abortion ,medicine.disease_cause ,California ,medicine ,Humans ,education ,Retrospective Studies ,Gynecology ,education.field_of_study ,biology ,Obstetrics ,business.industry ,Incidence (epidemiology) ,Obstetrics and Gynecology ,Toxic shock syndrome ,Clostridium perfringens ,biology.organism_classification ,medicine.disease ,Shock, Septic ,Medical abortion ,Clostridium Infections ,Female ,Death certificate ,business - 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.
- Published
- 2009
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