Lactococcus lactis cremoris intra-uterine infection: About an uncommon case report.

Extraperitoneal cesarean section Intra-uterine infection Lactococcus lactis cremoris

Journal

International journal of surgery case reports
ISSN: 2210-2612
Titre abrégé: Int J Surg Case Rep
Pays: Netherlands
ID NLM: 101529872

Informations de publication

Date de publication:
May 2022
Historique:
received: 11 03 2022
revised: 08 04 2022
accepted: 09 04 2022
pubmed: 24 4 2022
medline: 24 4 2022
entrez: 23 4 2022
Statut: ppublish

Résumé

When intra-uterine infection (IUI) is suspected or confirmed, intravenous antibiotic therapy providing coverage against common organisms (S. agalactiae and E. coli) is recommended to be administered immediately in order to reduce the risk of maternal and neonatal infectious complications. Nevertheless, it happens that some infections are due to uncommon microorganisms that do not respond to probabilistic treatment. Therefore, samples with bacteriological examination remain systematic. Moreover, the extraperitoneal cesarean section avoids the opening of the peritoneal cavity used in the Pfannenstiel technique and thus reduces the risk of infectious dissemination. We hereby present the uncommon case of a 19-year-old primigravida woman who was referred to our facility for acute gastroenteritis at 34 weeks of gestation. The hospital course was complicated by premature rupture of the membranes followed by the development of fever, chills and deterioration of the fetal heart rate (FHR), imposing an urgent extraperitoneal cesarean section for suspected IUI with fetal impact. Bacteriological examination of a placental sample subsequently yielded growth of Lactococcus lactis cremoris which makes it to our knowledge the second case reported to date of an IUI due to this bacterium. IUI predominantly occurs by ascending bacterial invasion from the lower genital tract to the typically sterile amniotic cavity in the setting of membrane rupture. Extraperitoneal cesarean section serves as a viable alternative to classic transperitoneal delivery in the presence of uterine infection by controlling bacterial spread. Our case serves as a reminder that IUI can arise from multiple pathogens, including Lactococcus lactis cremoris which is known as a harmless bacterium.

Sections du résumé

BACKGROUND BACKGROUND
When intra-uterine infection (IUI) is suspected or confirmed, intravenous antibiotic therapy providing coverage against common organisms (S. agalactiae and E. coli) is recommended to be administered immediately in order to reduce the risk of maternal and neonatal infectious complications. Nevertheless, it happens that some infections are due to uncommon microorganisms that do not respond to probabilistic treatment. Therefore, samples with bacteriological examination remain systematic. Moreover, the extraperitoneal cesarean section avoids the opening of the peritoneal cavity used in the Pfannenstiel technique and thus reduces the risk of infectious dissemination.
CASE PRESENTATION METHODS
We hereby present the uncommon case of a 19-year-old primigravida woman who was referred to our facility for acute gastroenteritis at 34 weeks of gestation. The hospital course was complicated by premature rupture of the membranes followed by the development of fever, chills and deterioration of the fetal heart rate (FHR), imposing an urgent extraperitoneal cesarean section for suspected IUI with fetal impact. Bacteriological examination of a placental sample subsequently yielded growth of Lactococcus lactis cremoris which makes it to our knowledge the second case reported to date of an IUI due to this bacterium.
CLINICAL DISCUSSION AND CONCLUSION UNASSIGNED
IUI predominantly occurs by ascending bacterial invasion from the lower genital tract to the typically sterile amniotic cavity in the setting of membrane rupture. Extraperitoneal cesarean section serves as a viable alternative to classic transperitoneal delivery in the presence of uterine infection by controlling bacterial spread. Our case serves as a reminder that IUI can arise from multiple pathogens, including Lactococcus lactis cremoris which is known as a harmless bacterium.

Identifiants

DOI: 10.1016/j.ijscr.2022.107077 PMID: 35461182 PMC: PMC9048150
pubmed: 35461182
pii: S2210-2612(22)00323-6
doi: 10.1016/j.ijscr.2022.107077
pmc: PMC9048150
pii:
doi:

Types de publication

Journal Article

Langues

eng

Pagination

107077

Informations de copyright

Copyright © 2022 The Authors. Published by Elsevier Ltd.. All rights reserved.

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Auteurs

Aziz Slaoui (A)

Gynaecology-Obstetrics and Endoscopy Department, Maternity Souissi, University Hospital Center IBN SINA, University Mohammed V, Rabat, Morocco; Gynaecology-Obstetrics and Endocrinology Department, Maternity Souissi, University Hospital Center IBN SINA, University Mohammed V, Rabat, Morocco. Electronic address: azizslaoui27@gmail.com.

Imane Benmouna (I)

Gynaecology-Obstetrics and Endocrinology Department, Maternity Souissi, University Hospital Center IBN SINA, University Mohammed V, Rabat, Morocco.

Najia Zeraidi (N)

Gynaecology-Obstetrics and Endocrinology Department, Maternity Souissi, University Hospital Center IBN SINA, University Mohammed V, Rabat, Morocco.

Amina Lakhdar (A)

Gynaecology-Obstetrics and Endocrinology Department, Maternity Souissi, University Hospital Center IBN SINA, University Mohammed V, Rabat, Morocco.

Aicha Kharbach (A)

Gynaecology-Obstetrics and Endoscopy Department, Maternity Souissi, University Hospital Center IBN SINA, University Mohammed V, Rabat, Morocco.

Aziz Baydada (A)

Gynaecology-Obstetrics and Endocrinology Department, Maternity Souissi, University Hospital Center IBN SINA, University Mohammed V, Rabat, Morocco.

Classifications MeSH