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Unexplained Fever in Obstetrics
Published in Benedict Isaac, Serge Kernbaum, Michael Burke, Unexplained Fever, 2019
This definition is not completely accurate since today we know that fever in the first 24 h, previously considered not to be connected to the delivery process, may be caused by genital infection, particularly in cases of prolonged PROM and protracted labor with repeated vaginal examinations, 33-35 internal intrapartum monitoring36 or postpartum uterine cavity revision. The infection may present as endometritis or parametritis. Signs vary from mild malaise to fulminating sepsis. Significant uterine tenderness is not invariably present. Retained secundines may cause fever, uterine bleeding, or passage of placental tissue. Curettage is indicated to remove these placental fragments. Treatment of metritis is by antibiotics for 10 days.13 Lack of response within 48 h requires reevaluation including a search for evidence of pelvic thrombophlebitis. Tuboovarian abscess discussed in the previous chapter may be a late sequel of metritis.15-21
P
Published in Anton Sebastian, A Dictionary of the History of Medicine, 2018
Pelvic Peritonitis or pelvic cellulitis [Greek: pyelos, oblong basin + peri, round + itis, inflammation] The first study was made in the mid-19th century by Nonat who described it as ‘peri-uterine phlegmon’ and the term ‘pelvic peritonitis’ was introduced Gustav Louis Richard Bernutz (1819–1887), around the same time. Rudolph Virchow (1821–1902) called it ‘parametritis’, to signify the involvement of other adjacent cellular tissues.
The puerperium
Published in Louise C Kenny, Jenny E Myers, Obstetrics, 2017
Infection may also spread directly into the myometrium and the parametrium, giving rise to an endometritis or parametritis, also referred to as pelvic cellulitis. Pelvic peritonitis and abscesses may also occur.
Hospitalizations for infections in primary Sjögren’s syndrome patients: a nationwide incidence study
Published in Annals of Medicine, 2022
Radjiv Goulabchand, Alain Makinson, Jacques Morel, Philine Witkowski-Durand-Viel, Nicolas Nagot, Paul Loubet, Camille Roubille, Danièle Noel, David Morquin, Kim Henry, Thibault Mura, Philippe Guilpain
We recorded the first occurrence of hospitalization for all pooled community infections, and all pooled opportunistic infections, in pSS and controls. We then recorded the first hospitalization for each infection within these groups. Conditions were identified according to their ICD-10 codes (Supplementary Table S2). Community infections of interest were: bronchopulmonary infections (pneumonia, bronchitis, flu); urinary tract infections, pyelonephritis, prostatitis; meningitis; skin infections (erysipelas, dermo-hypodermitis and skin abscesses); endocarditis and other sepsis (staphylococcus, Hemophilus influenzae, anaerobes, anaerobes or unspecified sepsis); phlegmon; dental and Ear–Nose–Throat (ENT) infections; abdominal infections (anorectal abscess, intestinal abscess or fistula, peritonitis, bacterial intestinal infections, cholecystitis, diverticulitis); pelvic infections (salpingitis and oophoritis, acute parametritis and pelvic cellulitis, diseases of Bartholin’s gland, vulvo-vaginitis); arthritis and bone infections (osteomyelitis, infection and inflammatory reaction due internal orthopaedic prosthetic devices, implants and grafts, infective spondylopathies and discitis).
Streptococcal toxic shock syndrome with primary group A streptococcus peritonitis in a healthy female
Published in Journal of Community Hospital Internal Medicine Perspectives, 2018
GAS peritonitis data is limited and involves sporadic case reports, case series and review articles [3,5–8]. According to a literature review of Malota et al., there is a female preponderance among 35 cases of GAS peritonitis, with a female to male ratio of 4: 1 and the median age of 38 [3]. Contrary to this, Iwata et al. collected data on female patients only and summarized 75 patients; fifty-five of them (73%) were below 50 [6]. This much higher incidence in women of childbearing age was attributed to the ascent of GAS from genital tract; this standpoint is based on the isolation of GAS from female organs, especially vagina [6]. Though most of the females were asymptomatic genital carriers of GAS, cases are outlined with concomitant vaginitis, cervicitis, endometritis/parametritis, salpingitis, oophoritis, ovarian abscess and pelvic abscess [5,6,9]. Apart from genital isolation, GAS has been isolated from the oropharynx of children and family members of the affected patients. In some instances, recent personal or family history of GAS pharyngitis has been reported [3]. Therefore, GAS pharyngitis has been implicated as a possible portal of entry in these cases. Besides these routes, Jonathan et al. proposed an orogenital route based on their case of GAS peritonitis in a female patient; an intrauterine device (IUD) was thought to be the portal of entry in her case [9]. The patient’s husband was an asymptomatic carrier of GAS in his oropharynx, and the couple was involved in oral sex. Similar GAS serotypes were isolated from IUD, the patient, and the oropharynx of her husband; circumstantially, that was the only possible route in this case [9].