Open AccessUncommon cause of pelvic inflammatory disease leading to toxic shock syndrome
Author(s) -
Heather Lusby,
Aaron Brooks,
Eden Hamayoun,
Amanda Finley
Publication year - 2018
Publication title -
bmj case reports
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.231
H-Index - 26
ISSN - 1757-790X
DOI - 10.1136/bcr-2018-224955
Subject(s) - medicine , pelvic inflammatory disease , chlamydia trachomatis , vomiting , gastroenterology , nausea , toxic shock syndrome , septic shock , sepsis , intensive care unit , abdominal pain , surgery , immunology , biology , bacteria , genetics , staphylococcus aureus
A 44-year-old Caucasian female with a history of endometriosis is admitted to the intensive care unit due to severe left lower quadrant abdominal pain, nausea and vomiting. With patients' positive chandelier sign on pelvic examination, leucocytosis, elevated erythrocyte sedimentation rate and elevated C-reactive protein indicated that she had pelvic inflammatory disease (PID). PCR tests were negative for Neisseria gonorrhoeae and Chlamydia trachomatis ; however, her blood and urine cultures grew Group A streptococci (GAS) with a negative rapid Streptococcus throat swab and no known exposure to Streptococcus On further review, patient met criteria for GAS toxic shock syndrome based on diagnostic guidelines. The patient was promptly treated with intravenous antibiotics and supportive care, and she acutely recovered. This case demonstrates a rare cause of PID and an atypical aetiology of severe sepsis. It illuminates the importance of considering PID as a source of infection for undifferentiated bacteraemia.