Fatal Toxic Shock Syndrome Associated with Clostridium sordellii after Medical Abortion
Marc Fischer, M.D., M.P.H., Julu Bhatnagar, Ph.D., Jeannette Guarner, M.D., Sarah Reagan, M.P.H., Jill K. Hacker, Ph.D., Sharon H. Van Meter, M.D., Vadims Poukens, M.D., David B. Whiteman, M.D., Anthony Iton, M.D., J.D., M.P.H., Michele Cheung, M.D., M.P.H., David E. Dassey, M.D., M.P.H., Wun-Ju Shieh, M.D., Ph.D., and Sherif R. Zaki, M.D., Ph.D.
Endometritis and toxic shock syndrome associated with Clostridiumsordellii have previously been reported after childbirth and,in one case, after medical abortion. We describe four deathsdue to endometritis and toxic shock syndrome associated withC. sordellii that occurred within one week after medically inducedabortions. Clinical findings included tachycardia, hypotension,edema, hemoconcentration, profound leukocytosis, and absenceof fever. These cases indicate the need for physician awarenessof this syndrome and for further study of its association withmedical abortion.
Source Information
From the Centers for Disease Control and Prevention, Atlanta (M.F., J.B., J.G., S.R., W.-J.S., S.R.Z.); the California Emerging Infections Program, Richmond (J.K.H.); the Alameda County Coroners Office (S.H.V.M.) and Health Department (A.I.), Oakland, Calif.; the Department of the Coroner (V.P., D.B.W.) and the Department of Health Services (D.E.D.), Los Angeles; and the Orange County Health Care Agency, Santa Clara, Calif. (M.C.).
Address reprint requests to Dr. Fischer at the Centers for Disease Control and Prevention, P.O. Box 2087, Mailstop P-02, Fort Collins, CO 80522, or at mfischer{at}cdc.gov.
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