Peptoniphilus asaccharolyticus Septic Abortion Precipitating Cerebral Venous Thrombosis

Peptoniphilus, a Gram-positive anaerobic coccus, is an opportunistic bacterium in the human microbiota. Obstetrics-associated Peptoniphilus asaccharolyticus infections are rarely reported, with only four reported cases, all patients recovered without complications. We describe a P. asaccharolyticus septic abortion at 8 weeks of gestation, complicated with cerebral venous thrombosis (CVT) and septic ileus. A 33 year-old Indonesian lady who is 8 weeks pregnant presented with sudden right-sided body weakness, with heavy vaginal bleeding and fever. She had attempted a self-induced abortion using over-the-counter medication prior to symptom onset. She was pale and septic. Besides evacuation of conception products, the patient was hospitalized for parenteral antibiotics therapy. Brain CT angiography revealed CVT. Anaerobic blood culture grew P. asaccharolyticus, identified via MALDI-TOF mass spectrometry. Her admission was complicated with septic ileus. Following eight days of antibiotics treatment, she requested a transfer to her hometown hospital for care continuation. P. asaccharolyticus is a disastrous organism to complicate septic abortions. Early clinical suspicion and prompt initiation of effective antibiotics are critical.