ABSTRACT
El término infección puerperal se utiliza para describir cualquier infección bacteriana del aparato genital después del parto. Durante gran parte del siglo XX las infecciones puerperales, la preeclampsia y la hemorragia obstétrica formaron parte de la tríada letal de mortalidad materna. La ecografía, la resonancia magnética y la tomografía axial computarizada son la triada de elección para el diagnóstico del abdomen agudo en el puerperio. El mismo resulta difícil debido a factores intrínsecos y es entonces, cuando el radiólogo adquiere un papel crucial. Se presentó un caso de una mujer de 30 años, con 8 días de habérsele practicado una cesárea con un puerperio inmediato normal. Posteriormente presentó dolor abdominal, fiebre, escalofríos y masa palpable en fosa iliaca izquierda. Se practicaron técnicas de imágenes se plantea una masa ovárica izquierda, se realizó laparotomía exploradora y se concluyó como absceso ovárico (AU).
The term puerperal infection is used to describe any bacterial infection of the genital tract after delivery. During much of the twentieth century puerperal infections, preeclampsia and obstetric hemorrhage were part of the lethal triad of maternal mortality. Ultrasonography, magnetic resonance imaging and computed tomography are the triad of choice for the diagnosis of acute abdomen in the puerperium, which is difficult due to intrinsic factors and it is when radiologist plays a vital role. The authors present the case of a woman, aged 30 years, at the 8th day after undergoing a cesarean section with a normal immediate puerperium, who later presented abdominal pain (AU).
Subject(s)
Humans , Female , Adult , Puerperal Infection/diagnosis , Women , Puerperal Disorders/diagnosis , Signs and Symptoms , Cesarean Section/methods , Abdomen, Acute/surgery , Laparotomy/methodsABSTRACT
Cryptococcus spp. cerebral abscesses are uncommon in immunocompetent subjects. The recommended induction treatment is the administration of amphotericin B plus flucytosine combined with resection for lesions ≥3cm. In this paper, we describe an HIV-negative woman diagnosed with a large cryptococcoma in the immediate postpartum period. The lesion was not resected, and due to amphotericin B intolerance, she received an extended course of fluconazole monotherapy. There was no disease recurrence during the 4 years of follow-up. The abrupt onset of her symptoms following delivery suggests that she developed a postpartum immune reconstitution syndrome. This case also demonstrates that in specific situations fluconazole monotherapy can be attempted in immunocompetent patients with cryptococcoma.
Subject(s)
Adult , Female , Humans , Antifungal Agents/therapeutic use , Fluconazole/therapeutic use , Meningitis, Cryptococcal/drug therapy , Puerperal Infection/drug therapy , Magnetic Resonance Imaging , Meningitis, Cryptococcal/diagnosis , Puerperal Infection/diagnosisABSTRACT
Se presenta el caso de un paciente masculino, recién nacido a término adecuado para la edad gestacional, quien nace por parto vaginal, con el antecedente de fiebre en la madre durante el periodo de postparto inmediato. Los padres consultan a los 2 días de vida pues le notan dificultad repiratoria, hipoactividad y rechazo a la leche materna. El paciente se interna y se aborda como una sepsis. Durante su estancia en el servicio de neonatología del Hospital Nacional de Niños asocia fallo respiratorio que amerita ventilación mecánica asistida por varios días en diferentes ocasiones, derrame pleural exudativo, convulsiones de origen hipóxico isquémico. Con reporte de hemocultivos positivos por estreptococos pyogenes. El esteptococos pyogenes o estreptococo b-hemolítico del grupo A, fue un problema en los comienzos del siglo pasado, siendo frecuente en las infecciones puerperales y del recién nacido. En la actualidad es un germen sumamente raro en los procesos de sepsis neonatal. La gravedad de la enfermedad causada por este microorganismo en el periodo neonatal varía desde una onfalitis crónica de bajo grado a una septicemia, una meningitis fulminante y la muerte. El presente artículo pretende hacer un resumen del paciente, con su evolución clínica, radiológica y además ejemplificar todas las complicaciones que tuvimos con este germen tan poco frecuente en la actualidad en sepsis neonatal.
We present herein the case of a newborn patient of appropriategestational age weight ( 3700 grams), born by vaginal delivery, from a mother that had had 2 previous pregnancies (2 normal deliveries). During the immediate puerperium she had fever.The parents consulted at the age of 2 days, stating that they had noticed difficult breathing since his birth, hipoactivity and poor appetite. He was admitted to the hospital and underwentseveral studies searching for the origin and germ causing the sepsis. He developed respiratory failure and needed mechanical ventilation for several days on different occasions. He had exudative pleural effusion and hypoxic ischemic seizures. Later on, his blood cultures were positive for Streptococcus pyogenes. Streptococcus pyogenes or Streptococcus β- hemolytic group A infection, used to be a common entity in the beginning of the past century, it was commonly associatedwith puerperal infections and newborn infections, but its incidence declined and nowadays, is uncommon during theneonatal period. Its clinical manifestations could vary fromchronic omphalitis up to a low grade septicemia or fulminant meningitis. Since its incidence has declined, at the present time; is an unusual infection of the neonatal period. Ampicillin and gentamicin are currently recommended as first-line antimicrobials, ampicillin replacing the previously recommended penicillin.
Subject(s)
Humans , Male , Infant, Newborn , Infant, Newborn , Puerperal Infection/diagnosis , Puerperal Infection/etiology , Puerperal Infection/physiopathology , Sepsis , Streptococcus pyogenesABSTRACT
Objetivos: Conhecer o índice de complicações maternas e fetais imediatas nas cesáreas eletivas realizadas nos Hospital São João Batista de Criciúma no período de janeiro a junho de 2008. Métodos: Estudo do tipo coorte prospectivo, observacional,exploratório e documental com 107 pacientes que foram submetidas à cesárea eletiva, sendo excluídasaquelas que entraram em trabalho de parto antes da cirurgia. Resultados: Das 107 pacientes estudadas, duas nãopreencheram os critérios de inclusão, resultando em 105 pacientes na amostra. A idade média das pacientes foide 27,3 anos, com idade mínima de 18 anos e idade máxima de 41 anos. Com relação à idade gestacional, a média foi 38,5 semanas, variando de 36 a 41 semanas. Neste estudo, foram observadas duas complicações imediatas; sendo uma materna e uma fetal. Das 105 pacientes submetidas à cesárea, uma (0,95%) apresentouinfecção puerperal; enquanto nos recém nascidos, um (0,95%) apresentou taquipnéia transitória. Conclusão: Concluiu-se nesse trabalho, que apesardo índice de complicações imediatas maternas e fetais evidenciados nas cesáreas eletivas ter sido de 0,95%, acesárea eletiva não é um procedimento isento de risco.
Objectives: To know the rate of immediate maternal and fetal complications in the elective cesareans achieved in São João Hospital in Criciúma, from January to June of 2008.Methods: Cohort prospective study, observational, exploratory and documental with 107 patients who weresubmitted to elective cesarean, excluding those one who started the delivery labor until the surgery.Results: From the 107 patients studied, two didnt fill includes criterion, resulting in 105 patients in the sample.The median age of the patients was 27,3 years, with the minimal of 18 years and the maximum of 41 years. About the gestational age, the median was 38,5 weeks, changing between 36 and 41 weeks. In this study, was observed two immediate complications; one maternal and one fetal. From the 105 patients submitted to cesarean, one (0,95%) presents puerperal infection; while in theinfant, one (0,95%) presents transient tachypnea. Conclusion: Concluded in this study, that although the rate of immediate maternal and fetal complications evidenced in the elective cesarean was about 0,95%, the elective cesarean is not a procedure without risks.
Subject(s)
Humans , Female , Adolescent , Adult , Middle Aged , Cesarean Section , Labor, Obstetric , Pregnancy Complications , Puerperal Infection , Cesarean Section/adverse effects , Cesarean Section/statistics & numerical data , Pregnancy Complications/diagnosis , Pregnancy Complications/epidemiology , Pregnancy Complications/physiopathology , Puerperal Infection/diagnosis , Puerperal Infection/metabolism , Puerperal Infection/pathology , Labor, Obstetric/physiology , Labor, Obstetric/metabolismABSTRACT
Human infections by Chromobacterium violaceum are rare. Till date 6 cases have been reported from southern and eastern parts of India. We report here a case of puerperal sepsis by C. violaceum, probably the first case from Eastern part of Orissa. The patient was successfully treated with amikacin and gatifloxacin.
Subject(s)
Academic Medical Centers , Adult , Amikacin/therapeutic use , Anti-Bacterial Agents , Chromobacterium/isolation & purification , Female , Fluoroquinolones/therapeutic use , Gram-Negative Bacterial Infections/diagnosis , Humans , India , Puerperal Infection/diagnosis , Sepsis/diagnosisABSTRACT
Nonpuerperal breast abscess (NPBA) has different etiology as compared to the mastitis occurring in post partum women. The condition presents either as acute suppurative infection or chronic type. Organisms usually implicated are Staphylococcus aureus, coagulase negative staphylococci, and anaerobes. Mostly the infection is polymicrobial in nature. Herein, we report the isolation of Enterococcus faecalis from a case of acute suppurative NPBA.
Subject(s)
Abscess/diagnosis , Breast Diseases/diagnosis , Diagnosis, Differential , Enterococcus faecalis/isolation & purification , Female , Gram-Positive Bacterial Infections/diagnosis , Humans , Mastitis/diagnosis , Middle Aged , Puerperal Infection/diagnosisABSTRACT
Informamos un caso clínico de trombosis de la vena ovárica derecha post-cesárea. Se discute los métodos diagnósticos, el diagnóstico diferencial y el tratamiento.
Subject(s)
Adolescent , Adult , Female , Pregnancy , Infant, Newborn , Infant , Child, Preschool , Child , Ovary/blood supply , Venous Thrombosis/diagnosis , Venous Thrombosis/therapy , Cesarean Section/adverse effects , Diagnosis, Differential , Puerperal Infection/diagnosis , Puerperal Infection/therapyABSTRACT
Las infecciones neonatales causadas por Streptococcus pneumoniae constituyen un fenómeno raro, poco reportado en la literatura médica; en el presente trabajo se describe el caso de una meningoencefalitis purulenta de aparición precoz, en un neonato nacido por parto eutócico, a termino y de buen peso. Se aisló el microorganismo en la sangre y en el líquido cefalorraquídeo del recién nacido, así como en los loquios de la madre. Las 3 antibiotipias fueron idénticas. La evolución del niño fue desfavorable, el cual falleció a las 81 horas de vida, en un cuadro de fallo multiorgánico. La necropsia corroboró el diagnóstico. La madre desarrolló una endometritis puerperal a los 4 días, con buena evolución.
Subject(s)
Humans , Infant, Newborn , Puerperal Infection/diagnosis , MeningoencephalitisABSTRACT
El presente capítulo trata los siguientes temas: retención de placenta, atonia uterina, infección puerperal y sepsis obstetrica
Subject(s)
Humans , Adult , Female , Pregnancy , Puerperal Infection/diagnosis , Placenta, Retained , Postpartum Hemorrhage , Bolivia , SepsisABSTRACT
Systemic fungal infections are rare. In pregnancy, treatment is problematic because of the risk of possible teratogenic effects of the antifungal drugs. We present the case of a 32 year-old woman who presented during pregnancy with a two-month history of painless subcutaneous nodules. Excision biopsy of one lesion showed dematiaceous fungal elements. Anti-fungal treatment was deferred and the pregnancy proceeded uneventfully. The remaining nodules were excised at the time of caesarean section delivery. Three weeks into the puerperium, she developed generalised seizures and investigations indicated systemic fungal infection with positive cultures for Aureobasidium spp which responded to appropriate antifungal therapy of flucytosine and itraconazole.
Subject(s)
Adult , Female , Humans , Pregnancy , Pregnancy Complications, Infectious/diagnosis , Puerperal Infection/diagnosis , Ascomycota/isolation & purification , Mycosis Fungoides/diagnosis , Pregnancy Complications, Infectious/drug therapy , Puerperal Infection/drug therapy , Skin/pathology , Tomography, X-Ray Computed , Itraconazole/therapeutic use , Flucytosine/therapeutic use , Mycoses/drug therapy , Antifungal Agents/therapeutic useSubject(s)
Humans , Female , Pregnancy , Infant, Newborn , Cross Infection , Puerperal Infection , Mastitis/diagnosis , Mastitis/therapy , Puerperal Infection/diagnosis , Puerperal Infection/etiology , Puerperal Infection/physiopathology , Puerperal Infection/prevention & control , Puerperal Infection/therapySubject(s)
Humans , Female , Pregnancy , Puerperal Infection/diagnosis , Postpartum Period/physiology , Puerperal Disorders/diagnosis , Contraceptives, Oral, Synthetic/adverse effects , Breast Feeding/adverse effects , Contraceptives, Oral/adverse effects , Practice Guidelines as Topic , Postpartum Hemorrhage/etiology , Venous Thrombosis/classification , Venous Thrombosis/diagnosisABSTRACT
Os autores avaliaram retrospectivamente a sensibilidade e especificidade dos criterios clinicos e laboratoriais utilizados no diagnostico de infeccao puerperal em 145 pacientes, bem como as intercorrencias durante o puerperio em um grupo controle composto por 145 puerperas que nao desenvolveram infeccao puerperal. Dados sugestivos de infeccao puerperal ao exame fisico foram observados em 92,4 por cento das pacientes que desenvolveram infeccao, sendo que nas pacientes com endometrite e infeccao do trato urinario o exame fisico apresentou menos elementos do que o habitualmente descrito...
Subject(s)
Humans , Female , Pregnancy , Adolescent , Adult , Clinical Trial , Fever/etiology , Puerperal Infection/diagnosis , Cephalothin/administration & dosage , Cephalothin/therapeutic use , Puerperal Infection/classification , Puerperal Infection/drug therapy , Sensitivity and SpecificityABSTRACT
Este trabalho teve como objetivo demonstrar a importância do exame citológico de Papanicolaou como exame de rotina nas grávidas atendidas no Serviço de Pré-Natal da Escola Paulista de Medicina, de 1983 a 1989. Correlacionamos em 73 casos, o exame citológico compatível com atipia coilocitótica com os achados colposcópicos e os anatomopatológicos. Em 143 resultados citológicos positivos, 73 (51 por cento) foram submetidos à exame colposcópico (12 apresentaram lesöes condilomatosas). Em 45 (73,8 por cento) dos 61 casos restantes, epitelio branco foi a lesäo colposcópica mais freqüentemente encontrada. Os achados histopatológicos foram a displasia associada a atipia coilocitítica em 36 por cento de displasias e Ca in situ em 18,8 por cento. O estudo ressalta a importância da investigaçäo rotineira através da colposcopia e da biopsia orientada, nos casos de alteraçöes coilocitóticas (HPV) detectadas a luz do exame de Papanicolaou.
Subject(s)
Humans , Female , Pregnancy , Colposcopy , Uterine Cervical Diseases/diagnosis , Papillomavirus Infections/diagnosis , Vaginal Smears , Puerperal Infection/diagnosisABSTRACT
Foram comparadas duas formas de administracao de antibioticos, orientadas por duas classificacoes distintas do risco de contaminacao em procedimentos obstetricos. O estudo inclui 3347 pacientes submetidas a procedimentos obstetricos durante o ano de 1990. Observou-se uma reducao significativa do indice de infeccao puerperal de 6,72 para 2,59 por cento com a introducao de uma classificacao mais rigorosa do risco de contaminacao e de antibioticoterapia profilatica. Os autores concluem que a utilizacao profilatica de antibioticos orientada por uma classificacao rigorosa do risco de contaminacao em procedimentos obstetricos foi eficiente na reducao do indice de infeccao puerperal.
Subject(s)
Humans , Female , Pregnancy , Adolescent , Adult , Evaluation of Results of Preventive Actions , Puerperal Infection/epidemiology , Cephalothin/administration & dosage , Cephalothin/therapeutic use , Puerperal Infection/diagnosis , Puerperal Infection/therapy , Risk Factors , Thiamphenicol/administration & dosage , Thiamphenicol/therapeutic useABSTRACT
Se presenta un caso de una paciente que presentó en el puerperio mediato un cuadro clínico caracterizado por estado de choque, con alteraciones hepáticas, renales y del aparato musculoesquelético, a sí como una erupción eritematosa generalizada, el cual fue catalogado como un síndrome de choque tóxico, de tipo obstétrico, y el hemocultivo mostró estafilococo dorado como único germen infectante. Fue manejada en la Unidad d eCuidados Intensivos Adultos (UCIA), con medidas de sostén para su estado de choque y con eritromicina por vía oral, siendo su evolución muy favorable. Se revisan las características epidemiológicas, factores de riesgo, hallazgos clínicos, criterios para diagnóstico y recomendaciones para su tratamiento