A Woman with Fever, Abdominal Pain, and Hypotension after Cesarean SectionCase 33-2009: A 35-Year-Old Woman with Fever, Abdominal Pain, and Hypotension after Cesarean Section

被引：8

作者：

de Moya, Marc A. ^{[1
,9
]}

del Carmen, Marcela G. ^{[2
,10
]}

Allain, Rae M. ^{[3
,11
]}

Hirschberg, Ronald E. ^{[4
,8
,12
]}

Shepard, Jo-Anne O. ^{[5
,13
]}

Kradin, Richard L. ^{[6
,7
,14
,15
]}

机构：

[1] Massachusetts Gen Hosp, Div Trauma Emergency Surg & Surg Crit Care, Boston, MA 02114 USA

[2] Massachusetts Gen Hosp, Div Gynecol Oncol, Boston, MA 02114 USA

[3] Massachusetts Gen Hosp, Dept Anesthesia & Crit Care, Boston, MA 02114 USA

[4] Massachusetts Gen Hosp, Dept Phys Med & Rehabil, Boston, MA 02114 USA

[5] Massachusetts Gen Hosp, Dept Radiol, Boston, MA 02114 USA

[6] Massachusetts Gen Hosp, Dept Med, Boston, MA 02114 USA

[7] Massachusetts Gen Hosp, Dept Pathol, Boston, MA 02114 USA

[8] Spaulding Rehabil Hosp, Dept Phys Med & Rehabil, Boston, MA USA

[9] Harvard Univ, Sch Med, Dept Surg, Boston, MA 02115 USA

[10] Harvard Univ, Sch Med, Dept Obstet Gynecol & Reprod Biol, Boston, MA 02115 USA

[11] Harvard Univ, Sch Med, Dept Anesthesia, Boston, MA 02115 USA

[12] Harvard Univ, Sch Med, Dept Phys Med & Rehabil, Boston, MA 02115 USA

[13] Harvard Univ, Sch Med, Dept Radiol, Boston, MA 02115 USA

[14] Harvard Univ, Sch Med, Dept Med, Boston, MA 02115 USA

[15] Harvard Univ, Sch Med, Dept Pathol, Boston, MA 02115 USA

来源：

NEW ENGLAND JOURNAL OF MEDICINE | 2009年 / 361卷 / 17期

关键词：

TOXIC-SHOCK-SYNDROME; A STREPTOCOCCUS INFECTIONS; SOFT-TISSUE INFECTION; TUMOR-NECROSIS-FACTOR; NECROTIZING FASCIITIS; SEPTIC SHOCK; SEVERE SEPSIS; MANAGEMENT; PYOGENES; THERAPY;

D O I：

10.1056/NEJMcpc0900646

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

A 35-year-old woman was transferred to this hospital because of abdominal pain, fever, and hypotension 3 days after an elective cesarean section. On examination, she appeared acutely ill. The temperature was 39.2°C, the blood pressure 70/52 mm Hg, and the pulse 149 beats per minute. The abdomen was distended and very tender, with rebound. There was erythema and edema in the region of the surgical incision, extending to the left flank, with no drainage. A diagnostic procedure was performed. Copyright © 2009 Massachusetts Medical Society.

引用

页码：1689 / 1697

页数：9

共 24 条

[1] Necrotizing soft-tissue infection: Diagnosis and management [J].

Anaya, Daniel A. ;

Dellinger, E. Patchen .

CLINICAL INFECTIOUS DISEASES, 2007, 44 (05) :705-710

[2]

[Anonymous], CIRCULATION S4

[3]

Anteby E Y, 1999, Infect Dis Obstet Gynecol, V7, P276, DOI 10.1155/S1064744999000514

[4] Efficacy and safety of recombinant human activated protein C for severe sepsis. [J].

Bernard, GR ;

Vincent, JL ;

Laterre, P ;

LaRosa, SP ;

Dhainaut, JF ;

Lopez-Rodriguez, A ;

Steingrub, JS ;

Garber, GE ;

Helterbrand, JD ;

Ely, EW ;

Fisher, CJ .

NEW ENGLAND JOURNAL OF MEDICINE, 2001, 344 (10) :699-709

[5] Population-based surveillance for postpartum invasive group A streptococcus infections, 1995-2000 [J].

Chuang, I ;

Van Beneden, C ;

Beall, B ;

Schuchat, A .

CLINICAL INFECTIOUS DISEASES, 2002, 35 (06) :665-670

[6] Intravenous immunoglobulin G therapy in streptococcal toxic shock syndrome:: A European randomized, double-blind, placebo-controlled trial [J].

Darenberg, J ;

Ihendyane, N ;

Sjölin, J ;

Aufwerber, E ;

Haidl, S ;

Follin, P ;

Andersson, J ;

Norrby-Teglund, A .

CLINICAL INFECTIOUS DISEASES, 2003, 37 (03) :333-340

[7] SEVERE NECROTIZING SOFT-TISSUE INFECTIONS - MULTIPLE DISEASE ENTITIES REQUIRING A COMMON APPROACH [J].

DELLINGER, EP .

JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 1981, 246 (15) :1717-1721

[8]

Dellinger RP, 2008, CRIT CARE MED, V36, P1394

[9] Surviving Sepsis Campaign: International guidelines for management of severe sepsis and septic shock: 2008 [J].

Dellinger, R. Phillip ;

Levy, Mitchell M. ;

Carlet, Jean M. ;

Bion, Julian ;

Parker, Margaret M. ;

Jaeschke, Roman ;

Reinhart, Konrad ;

Angus, Derek C. ;

Brun-Buisson, Christian ;

Beale, Richard ;

Calandra, Thierty ;

Dhainaut, Jean-Francois ;

Gerlach, Herwig ;

Harvey, Maurene ;

Marini, John J. ;

Marshall, John ;

Ranieri, Marco ;

Ramsay, Graham ;

Sevransky, Jonathan ;

Thompson, B. Taylor ;

Townsend, Sean ;

Vender, Jeffrey S. ;

Zimmerman, Janice L. ;

Vincent, Jean-Louis .

CRITICAL CARE MEDICINE, 2008, 36 (01) :296-327

[10] TOXIC SHOCK SYNDROME-ASSOCIATED STAPHYLOCOCCAL AND STREPTOCOCCAL PYROGENIC TOXINS ARE POTENT INDUCERS OF TUMOR NECROSIS FACTOR PRODUCTION [J].

FAST, DJ ;

SCHLIEVERT, PM ;

NELSON, RD .

INFECTION AND IMMUNITY, 1989, 57 (01) :291-294

← 1 2 3 →