Staphylococcal toxic shock syndrome in a lactating mother with breast abscess: A case report

Maternal Sepsis

Sepsis is the second leading cause of pregnancy-related mortality in the United States. Early recognition, treatment, and escalation of care for the obstetric patient affected by sepsis mitigate the risk of mortality and improve patient outcomes. In this article, we provide an overview of maternal sepsis and address topics of maternal pathophysiology, early warning signs, diagnostic criteria, early goal-directed therapy, and contemporary critical care practices. We also present an overview of common etiologies of maternal sepsis and suggested treatment approaches.

Management of life-threatening staphylococcal septic shock in a breastfeeding woman with breast abscess: A case report

Introduction and importance

Breast abscess is a common problem in breastfeeding women. However, septic shock secondary to methicillin resistant Staphylococcus aureus (MRSA) from breast abscess is very rare. Successful management of this condition in our center may provide experience of treatment for similar patients.

Case presentation

A 20-year-old breastfeeding woman with breast abscess was transferred to our center. General condition of the patient deteriorated rapidly to life-threatening septic shock. Culture of pus later demonstrated MRSA infection, with vancomycin susceptibility. Several measures were emergently implemented, including removal of necrotic tissue, continuous catheter irrigation and drainage, intravenous infusion of vancomycin, pumping norepinephrine, fluid resuscitation and transfusion of plasma. The patient was cured and discharged after 10 day's treatment.

Clinical discussion

Life-threatening septic shock secondary to MRSA in breastfeeding women with breast abscess is very rare. Nevertheless, clinicians should remain vigilant to early symptoms and signs of septic shock. Catheter irrigation and drainage, vancomycin and fluid resuscitation are essential for septic shock in lactational breast abscess.

Conclusions

We highlight the importance of the diagnosis and management of life-threatening septic shock secondary to MRSA in breast abscess to help us further understand this rare and fatal disease.

•

Life-threatening septic shock secondary to MRSA in a breastfeeding woman with breast abscess is very rare.

•

We should pay more attention to the early symptoms and signs of septic shock.

•

Catheter irrigation and drainage, vancomycin and fluid resuscitation are essential for septic shock in breast abscess.