Postpartum Endometritis With Group C/G Streptococcus: A Case Report

Postpartum endometritis is a primary cause of postpartum fever and can lead to serious complications such as maternal sepsis and death. In this recent case of postpartum endometritis, the patient was infected with Streptococcus dysgalactiae subspecies equisimilis (group C or G). This opportunistic bacterium is considered a normal component of vaginal flora and has not been previously identified as a cause of postpartum infections.

In this case, a 40-year-old G1P1 patient presented on postpartum day 2 after term vaginal delivery with fever, body aches, and chills. Her initial temperature was 39.4°C with fundal tenderness on physical examination. On initial presentation, cultures were taken, and the patient was started on intravenous gentamicin and clindamycin. Antibiotics were later changed to ceftriaxone after blood, vaginal, and urine cultures showed Streptococcus dysgalactiae subspecies equisimilis. The patient quickly defervesced and was discharged 3 days after admission.

To the best of our knowledge, this is the first documented case of spontaneous Streptococcus dysgalactiae subspecies equisimilis infection of the female genital tract. This case is important because it demonstrates a pathogen that clinicians should be aware of, particularly given recent reports of increasing virulence.