Spontaneous Streptococcus pyogenes pelvic inflammatory disease; Case report and review of the literature. (2020)

• Record Type: Journal Article
• Authors: Snyder, A; Schmalzle, SA
• Is Part Of: IDCases. Volume 20(2020)
• Publication Date: 2020
• Subjects: Streptococcus pyogenes -- Group a strep -- Pelvic inflammatory disease -- Gynecology -- Salpingitis -- Endometritis; Communicable diseases -- Periodicals; Communicable Diseases -- Case Reports; Communicable Diseases -- Periodicals; Communicable diseases; Periodicals; 616.9
• DOI: 10.1016/j.idcr.2020.e00785
• Languages: English
• ISSNs: 2214-2509

Abstract

Abstract: Streptococcus pyogenes gynecological infections generally occur in association with childbirth, intra-uterine devices, and other invasive gynecologic procedures, but rarely cause spontaneous pelvic inflammatory disease. We describe a case of a healthy young woman with spontaneous S. pyogenes pelvic inflammatory disease, bacteremia, and shock, and summarize an additional 13 cases found in the literature. The majority were bacteremic and a significant number were also hypotensive. The same proportion had presenting gastrointestinal symptoms as had genitourinary symptoms, masking the diagnosis in many. Many prior case reports postulate a connection with S. pyogenes pharyngitis in a close contact, and an oro-genital route of transmission has been proposed given the exceedingly low rates of genital colonization with S. pyogenes . A high index of suspicion is needed for an accurate and timely diagnosis of this rare but potentially fatal condition.