Journal of Infectious Diseases & Therapy
Open Access

Abstract

Group A streptococcus (GAS)-induced toxic shock syndrome (TSS) in pregnancy is rare, but its clinical course is fulminant. Mortality of GAS-induced toxic-shock syndrome is high as 50%. Here, we report two obstetrics cases from South-East Coast of Sabah, Malaysia. The first case was 23 year old lady presented with preterm labour at 24 weeks. She was in severe septic shock at presentation that requires three inotropes support. Her condition deteriorate very fast despite broad spectrum antibiotic and metronidazole, she succumbed within 24 hours from admission. Post mortem was done for her showed tissue culture from multiple organs grew GAS. While in other case, 23 year old lady at 34 weeks initially presented with shortness of breath with elevated blood pressure which been treated as acute pulmonary oedema secondary to severe pre-eclampsia. Her chest X-ray also suggestive of pneumonia was treated with ceftriaxone and azithromycin. An emergency lower segment caesarean section was done as her condition was worsening, severe metabolic acidosis requiring haemodialysis, difficulty in maintaining ventilation and needing inotropes to support her blood pressure. Post operatively, she was monitored in intensive care unit and antibiotics were changed to C-Penicillin and Clindamycin as her blood culture grew GAS which was sensitive to both. She had good recovery period after completion of antibiotics for 10 days and discharged well home. Unfortunately, both baby for these two women did not survive. The clinical manifestation is varied thus it is challenging in making diagnosis and subsequently delivering early management.

Biography

Nuryuziliana Dolmat (Yuzi) is currently working as Obstetrician and Gynecologist at Tawau General Hospital, Tawau Sabah. She completed her Masters of Obstetrics & Gynaecology from the University of Malaya. She worked at Sabah Women and Children Hospital as a Specialist and then promoted as Head of Department in Obstetric Department in Tawau General Hospital. She had involved with many teaching session for post graduate student in O&G.
Email:widuri_183@yahoo.com