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Preterm labor and neonatal sepsis caused by intrauterine Helicobacter cinaedi infection
Yohei Maki1, Seishi Furukawa1, Yuki Kodama1
1Department of Obstetrics and Gynecology, University of Miyazaki, Japan.
Abstract:
Helicobacter cinaedi is a rare pathogen but known to cause bacteremia, cellulitis and enterocolitis. Recently, cases of involving various organs are increasingly reported such as endocarditis, meningitis, and kidney cyst infection. We report a case of intrauterine H. cinaedi infection leading preterm birth and neonatal sepsis. A 29-year-old pregnant women who was no underlying disease hospitalized due to threatened preterm labor at 22 weeks of gestation. Clinical findings showed uterine tenderness, fever, leukocytosis and elevated C-reactive protein. H. cinaedi was isolated from amniotic fluid obtained by transabdominal amniocentesis. We diagnosed as intrauterine H. cinaedi infection and administered intravenous ampicillin followed by oxytocin to terminate pregnancy. A live 446 g male infant was delivered. The patient was no signs of infection throughout postpartum course and discharged on post-delivery day 5. The neonate was admitted in neonatal intensive care unit and administered ampicillin and amikacin. H. cinaedi was isolated from umbilical cord blood culture. He has no signs of infection on day 5 but died from uncontrollable hyperglycemia and ketoacidosis on 15 days of age. H. cinaedi can cause intrauterine infection during pregnancy and lead preterm labor and neonatal sepsis.
Insights
Helicobacter cinaedi can infect the uterus during pregnancy, leading to preterm labor and sepsis in newborns. This rare bacterial infection requires prompt diagnosis and treatment to improve maternal and infant outcomes.
Area of Science:
- Medical Microbiology
- Infectious Diseases
- Obstetrics and Gynecology
Background:
- Helicobacter cinaedi is an emerging pathogen associated with various infections.
- While known for bacteremia and enterocolitis, its role in intrauterine infections is less understood.
Observation:
- A pregnant woman at 22 weeks gestation presented with threatened preterm labor and signs of infection.
- Helicobacter cinaedi was identified in amniotic fluid via transabdominal amniocentesis.
- The neonate developed sepsis, with H. cinaedi confirmed in umbilical cord blood.
Findings:
- The case demonstrates a rare instance of intrauterine Helicobacter cinaedi infection.
- The infection resulted in preterm birth and severe neonatal sepsis.
- Despite treatment, the neonate succumbed to complications of hyperglycemia and ketoacidosis.
Implications:
- Highlights the potential for H. cinaedi to cause severe intrauterine infections.
- Emphasizes the need for considering H. cinaedi in pregnant patients with preterm labor and signs of infection.
- Underscores the critical importance of early diagnosis and management of H. cinaedi in pregnancy to prevent adverse neonatal outcomes.
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