Cultures from 276 patients with fever following obstetrical and gynecological procedures were collected during a one-year period (1975). Anaerobic septicemia was found in 15 (5.4%) and aerobic septicemia in 16 (5.8%). In 13 patients the clinical course was mild, but in two the course was more fulminating. One of the latter developed septic shock and mild disseminated intravascular coagulation. She recovered after clindamycin therapy for Bacteroides fragilis septicemia. One patient required abdominal hysterectomy following spontaneous uterine rupture during delivery. She developed postoperative sepsis due to Bacteroides fragilis, recovered clinically and was discharged after treatment, but died at home 17 days following surgery. The exact cause of death is unknown. Laboratory findings in most cases showed leukocytosis, increased sedimentation rate and anemia. The blood clotting mechanism was found to be normal in all but the patient with intravascular coagulation. Early diagnosis, early isolation of anaerobic puthogens, and effective antibiotic therapy were probably responsible for the benign clinical course in the majority of our cases.
|State||Published - 1979|