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首页> 外文期刊>Case Reports in Obstetrics and Gynecology >Maternal and Fetal Death following Group A Streptococcal Meningitis in Mid-Term Pregnancy
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Maternal and Fetal Death following Group A Streptococcal Meningitis in Mid-Term Pregnancy

机译：中期妊娠A组链球菌性脑膜炎后的产妇和胎儿死亡

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摘要

Background. Group A streptococcal (GAS) meningitis is rarely seen in the antenatal period, but it is associated with significant mortality. We present a case of a mid-trimester woman who developed fulminant meningitis following a rapid onset atypical presentation of infection with this organism.Case. A multiparous 23+5-week woman presented with a 10-day history of a non-productive cough associated with pyrexia. Within minutes of her admission she collapsed and lost consciousness; sepsis was suspected and cross-specialty care was initiated. She was managed empirically in extremis with broad-spectrum antibiotics and mannitol with 3% hypertonic saline for suspected infection and raised intracranial pressure, respectively. Despite intensivist management, a CT head revealed diffuse oedema with coning of the cerebellar tonsils. Brainstem death was certified within 19 hours of admission and fetal death ensued. Postmortem bacteriology confirmed GAS meningitis.Conclusion. Through raising awareness of this patient and her disease course, we hope that future policy decisions, primary care, and hospital level management will be informed accordingly for treatment of pregnant women with suspected GAS infection.
机译：背景。 A组链球菌（GAS）脑膜炎在产前期很少见，但与死亡率高相关。我们提出了一例中孕期妇女，该妇女在快速非典型性感染此病原体后发展为暴发性脑膜炎。一位多产的23 + 5周妇女表现出与发热相关的非生产性咳嗽的10天病史。入院后几分钟，她昏倒了，失去了知觉。怀疑患有败血症，并开始了跨专业治疗。根据经验，分别对她进行了可疑感染和颅内压升高的广谱抗生素和含3％高渗盐水的甘露醇治疗。尽管进行了强化治疗，但CT头显示小脑扁桃体锥状弥漫性水肿。脑干死亡在入院后19小时内被确认，随后发生胎儿死亡。死后细菌学证实为GAS脑膜炎。通过提高对该患者及其疾病病程的认识，我们希望能为治疗可能的GAS感染的孕妇提供相应的未来政策决定，初级保健和医院级管理。

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