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Maternal puerperal infection caused by Parabacteroides goldsteinii: a case report
Liwei Peng1, Xiaomin Chen2, Zhenhui Wang1
1Department of Clinical Laboratory, Maternal and Child Health Hospital of Hubei Province, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Background:
Parabacteroides goldsteinii, a member of the Parabacteroides genus, was initially discovered in the feces and abdominal tissue of patients with appendicitis, peritonitis, and abdominal abscesses. In recent years, P. goldsteinii has been widely regarded as a gut probiotic, and human infections have been extremely rare. In 2010, P. goldsteinii was first isolated from the blood culture of a patient with abdominal infection, confirming its ability to cause bacteremia. In this study, we report a rare case of puerperal infection with septic shock caused by P. goldsteinii infection in a pregnant woman.
Case Presentation:
A 31-year-old female experienced perineal lacerations, cervical lacerations, and postpartum hemorrhage during childbirth. Nine days postpartum, the patient developed septic shock, and P. goldsteinii infection was identified through blood culture and mass spectrometry. We administered broad-spectrum antibiotics, including meropenem/nalidixic acid and piperacillin tazobactam, intravenously, but the antimicrobial effect was not satisfactory. Upon ultrasound examination, we identified a focus of infection in the patient's uterus. Subsequently, uterine curettage was performed, followed by uterine cavity irrigation with metronidazole and intramuscular injection of gentamicin and dexamethasone. Following treatment, the patient's physiological parameters gradually returned to normal, and she was discharged 30 days after admission.
Conclusion:
Parabacteroides goldsteinii bacteraemia is extremely rare, and clinically, the postinfection toxicity of this bacterium appears to be significant. In this report, we review the research history of P. goldsteinii and relevant infection cases, aiming to enhance awareness among clinical practitioners, particularly obstetricians and gynecologists, regarding P. goldsteinii bloodstream infections, facilitating early diagnosis and timely treatment.
Insights
This study reports a rare case of puerperal infection and septic shock caused by Parabacteroides goldsteinii in a postpartum woman. Early diagnosis and treatment are crucial for managing this severe, though uncommon, bloodstream infection.
Area of Science:
- Microbiology
- Infectious Diseases
- Obstetrics & Gynecology
Background:
- Parabacteroides goldsteinii, a gut bacterium, is rarely pathogenic.
- Historically associated with abdominal infections, P. goldsteinii has recently been considered a probiotic.
- Human infections, particularly bacteremia, are exceptionally rare.
Observation:
- A 31-year-old woman developed septic shock nine days postpartum.
- P. goldsteinii was identified as the causative agent via blood culture and mass spectrometry.
- Initial broad-spectrum antibiotics were ineffective, necessitating further intervention.
Findings:
- The patient underwent uterine curettage and received targeted antimicrobial therapy.
- Successful treatment led to the patient's recovery and discharge.
- This case highlights the potential severity of P. goldsteinii infections.
Implications:
- Clinicians, especially obstetricians and gynecologists, should be aware of P. goldsteinii bacteremia.
- Prompt diagnosis and appropriate treatment are vital for managing rare but severe postpartum infections.
- Further research into P. goldsteinii pathogenicity and treatment is warranted.
