Streptococcal toxic shock syndrome in the immediate postpartum period

In the puerperal phase, streptococcal toxic shock syndrome is a relatively uncommon occurrence. However, there has been a rise in the prevalence of more aggressive strains of Group A Streptococcus (GAS), leading to significant maternal morbidity and mortality. In this report, we present a case of a postpartum patient who developed streptococcal toxic shock syndrome with substantial inflammation shortly after delivery. The patient presented on the second postpartum day with hypotension, high fever, hypogastric tenderness and anaemia. After timely workup and appropriate antibiotic therapy, the patient fully recovered. Culture studies confirmed Gram-positive septicaemia with the presence of <i>Streptococcus pyogenes</i> in both the patient's blood and a previously inserted intrauterine device (IUD). This case underscores the importance of maintaining a high index of suspicion for GAS as the cause of puerperal infections despite its rarity. This results in prompt administration of antibiotics and source control, preventing consequences and avoiding mortality.

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Publication Details

Journal
BMJ Case Reports
Published
2025-02-01
DOI
https://doi.org/10.1136/bcr-2023-258863
Primary Topic
Streptococcal Infections and Treatments
Type
article
Field-Weighted Citation Impact
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article

Streptococcal toxic shock syndrome in the immediate postpartum period

Dana Lee Macasaet Benitez, Patricia Ann Africa Factor
BMJ Case Reports
Streptococcal Infections and Treatments
article

Streptococcal toxic shock syndrome in the immediate postpartum period

Dana Lee Macasaet Benitez, Patricia Ann Africa Factor
article en

Abstract

In the puerperal phase, streptococcal toxic shock syndrome is a relatively uncommon occurrence. However, there has been a rise in the prevalence of more aggressive strains of Group A Streptococcus (GAS), leading to significant maternal morbidity and mortality. In this report, we present a case of a postpartum patient who developed streptococcal toxic shock syndrome with substantial inflammation shortly after delivery. The patient presented on the second postpartum day with hypotension, high fever, hypogastric tenderness and anaemia. After timely workup and appropriate antibiotic therapy, the patient fully recovered. Culture studies confirmed Gram-positive septicaemia with the presence of <i>Streptococcus pyogenes</i> in both the patient's blood and a previously inserted intrauterine device (IUD). This case underscores the importance of maintaining a high index of suspicion for GAS as the cause of puerperal infections despite its rarity. This results in prompt administration of antibiotics and source control, preventing consequences and avoiding mortality.

BMJ Case ReportsVol. 18(2)
University of the Philippines Manila (PH)
Good health and well-being
Openalex Percentile: Top 96%
Streptococcal Infections and Treatments
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Streptococcal toxic shock syndrome in the immediate postpartum period — Dana Lee Macasaet Benitez, Patricia Ann Africa Factor · BMJ Case Reports (2025) | TGRS Research Map | TGRS