Abstract
Background Over the past few decades, physicians have been reminded of the potential for serious complications arising from group A streptococcal (GAS) infections. These infections continue to pose a serious threat, primarily because the pathophysiology of these infections is complex. This article reviews some of the features of GAS infections and presents two case reports of GAS pelvic infections in women. Purpose The two patients discussed both had unusual presentations for pelvic inflammatory disease. In both cases, there was strong concern that a serious gastrointestinal process was occurring. Both improved dramatically after aggressive irrigation of their abdominal cavities and administration of antibiotics. Conclusion Appropriate and aggressive use of antibiotics and reduction of bacterial load through debridement and irrigation are crucial in treating serious GAS infections. Infect. Dis. Obstet. Gynecol. 5:391–394, 1997. © 1998 Wiley-Liss, Inc.
Highlights
Over the past few decades, physicians have been reminded of the potential for serious complications arising from group A streptococcal (GAS) infections
KEY WORDS Group A streptococcus; pathogens; pelvic infections always have bstetrician-gynecologists been fascinated with group A streptococcus (GAS)
It is possible that the availability of newer antibiotics has decreased the incidence of GAS infections in childhood but has created a population of adults who may be more susceptible to GAS infections due to lack of exposure as children
Summary
Appropriate and aggressive use of antibiotics and reduction of bacterial load through debridement and irrigation are crucial in treating serious GAS infections. We want to report two recent cases of peritonitis resulting from GAS infections in gynecologic patients. The following morning, the patient noted the sudden onset of diffuse abdominal pain Prior to admission, she had noticed a thick, clear, odorless cervical discharge and dyspareunia for one week and a rectal discharge for one month. The patient reported vaginal irritation and was treated for a presumed yeast infection She recalled having enlarged cervical lymph nodes and a sore throat. On the day of admission, the patient was evaluated in the emergency room in response to reports of one day of intense abdominal pain, diarrhea, nausea, vomiting, and fever She was noted to have a temperature of 39C, a blood pressure of 123/65 mmHg, and a pulse of 113 bpm.
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