Chorioamnionitis caused by Staphylococcus aureus in a ten weeks pregnant patient

Abstract

Infections are the most important causes of chorioamnionitis. Causative bacteria are usually genital mycobacteria, anaerobes, enteric Gram-negative bacilli and group B streptococci. Staphylococcus aureus can also rarely be the causative agent. In this study a case of chorioamnionitis caused by Staphylococcus aureus was reported. A ten weeks pregnant was admitted to our hospital with fever, physical examination revealed lower quadrant tenderness. Therapeutic abortion was planned for the patient whose fetal heart sounds were not heard by ultrasound. The meropenem treatment was administered to the patient with the pre-diagnosis of chorioamnionitis after obtainined cultures. Then Staphylococcus aureus was growed in the blood cultures and in the cultures of amniotic membranes obtained during operation. The histopathologic examination of the amniotic membranes was reported as acute funisit and acute chorioamnionitis. The therapy was continued with cefazoline and completed in 14 days. As a result Staphylococcus aureus should also be considered as a causative agent in chorioamnionitis cases and the empirical therapy should be administered accordingly

Keywords

• pregnancy, chorioamnionitis, Staphylococcus aureus

On haftalık gebede Staphylococcus aureus’un etken olduğu koryoamniyonit

Öz

Koryoamniyonite yol açan en önemli neden enfeksiyondur. Etken bakteriler genellikle genital mikoplazmalar, anaeroblar, enterik gram-negatif basiller ve grup B streptokoklardır. Nadiren Staphylococcus aureus’da etken olabilmektedir. Bu çalışmada S. aureus’un etken olduğu koryoamniyonit vakası sunulmuştur. On haftalık bir gebe, yüksek ateş şikayetiyle hastanemize başvurmuş, fizik muayenesinde batında alt kadran hassasiyeti saptanmıştır. Yapılan ultrasonografide fetüs kalp sesi duyulamayan hastaya teröpatik abortus planlanmıştır. Koryoamniyonit ön tanısıyla tüm kültürleri alındıktan sonra ampirik meropenem tedavisi başlanmıştır. Operasyon sırasında alınan amniyon zarı kültüründe ve kan kültürlerinde S. aureus üremiştir. Amniyon zarının histopatolojik incelemesi akut funisit ve akut koryoamniyonit olarak rapor edilmiştir. Tedaviye sefazolin ile devam edilmiş, tedavisi 14 güne tamamlanmıştır. Sonuç olarak koryoamniyonit düşünülen hastalarda nadiren S. aureus’un da etken olabileceği bilinmeli ve ampirik antibiyotik tedavisi buna göre düzenlenmelidir

Anahtar Kelimeler

• gebelik, koryoamniyonit, Staphylococcus aureus

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