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Abstract
Clostridium sordellii is a common soil and enteric bacterium that is infrequently recovered from the vagina.
We describe three women in which C. sordellii caused puerperal infection and a distinctive and lethal toxic shock-like syndrome.
Patients were <1 week post partum and each had a single, limited focus of infection
including infection associated with a retained vaginal sponge, a cesarean section
operative site, and endometritis. Each patient had a distinctive course characterized
by sudden onset of clinical shock marked by severe and unrelenting hypotension associated
with marked, generalized tissue edema and “third spacing” with increased hematocrit,
presence of marked leukemoid reaction with total neutrophil counts of 84,000/mm3, 66,000/mm3, and 93,600/mm3, absence of rash or fever, limited or no myonecrosis, and a rapid and uniformly lethal
course. Hypoalbuminemia was also noted. Similar findings were noted in prior isolated
reports of C. sordellii-mediated postpartum or surgical infection. Treatment of animals with C. sordellii or closely related C. difficile toxins produces similar findings. We suggest that localized infection with toxin-producing
strains of C. sordellii can produce a rapidly lethal toxic shock-like syndrome. Further study and earlier
recognition of this syndrome may be life-saving in other patients.
Key Words
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Article info
Publication history
Accepted:
April 10,
1989
Received in revised form:
March 13,
1989
Received:
October 26,
1988
Identification
Copyright
© 1989 Mosby. Published by Elsevier Inc. All rights reserved.
