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Hopkins AM, Desravines N, Stringer EM, Zahn K, Webster CM, Krajick K, Vora NL. Capnocytophaga bacteremia precipitating severe thrombocytopenia and preterm labor in an asplenic host. Infect Dis Rep 2019; 11:8272. [PMID: 31857872 PMCID: PMC6902302 DOI: 10.4081/idr.2019.8272] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2019] [Accepted: 10/28/2019] [Indexed: 11/30/2022] Open
Abstract
Capnocytophaga species are gram-negative bacilli that inhabit mammalian oral surfaces and can cause opportunistic infection, especially in asplenic patients. The species Capnocytophaga canimorsus is particularly associated with dog bites and is known to cause endocarditis, meningitis, and sepsis in the general population. In pregnant patients, infections tied to Capnocytophaga species from human flora have been associated with preterm labor, chorioamnionitis, and neonatal septicemia. There is little known about the effects of zoonotically-acquired Capnocytophaga infection in pregnant patients. In this case report, we present a patient with Capnocytophaga bacteremia acquired after a dog bite associated with profound thrombocytopenia and preterm labor. Dog bites are common in the United States, and we present basic recommendations for management of dog bites in pregnant patients in order to avoid morbidity associated with delay in time to antibiotic treatment of infection as described in this case.
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Affiliation(s)
- Austin M Hopkins
- University of North Carolina School of Medicine, Chapel Hill, NC
| | - Nerlyne Desravines
- Department of Obstetrics & Gynecology, University of North Carolina School of Medicine, Chapel Hill, NC
| | - Elizabeth M Stringer
- Division of Maternal Fetal Medicine, Department of Obstetrics & Gynecology, University of North Carolina School of Medicine, Chapel Hill, NC, USA
| | - Katelin Zahn
- Department of Obstetrics & Gynecology, University of North Carolina School of Medicine, Chapel Hill, NC
| | - Carolyn M Webster
- Division of Maternal Fetal Medicine, Department of Obstetrics & Gynecology, University of North Carolina School of Medicine, Chapel Hill, NC, USA
| | - Kayla Krajick
- University of North Carolina School of Medicine, Chapel Hill, NC
| | - Neeta L Vora
- Division of Maternal Fetal Medicine, Department of Obstetrics & Gynecology, University of North Carolina School of Medicine, Chapel Hill, NC, USA
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2
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Affiliation(s)
- Sarah M Marsicek
- 1 Johns Hopkins All Children's Hospital, Saint Petersburg, FL, USA
| | - David Berman
- 1 Johns Hopkins All Children's Hospital, Saint Petersburg, FL, USA
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3
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Fox C, Eichelberger K. Maternal microbiome and pregnancy outcomes. Fertil Steril 2015; 104:1358-63. [PMID: 26493119 DOI: 10.1016/j.fertnstert.2015.09.037] [Citation(s) in RCA: 81] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2015] [Revised: 09/14/2015] [Accepted: 09/25/2015] [Indexed: 01/14/2023]
Abstract
Alterations of the human microbiome are a known characteristic of various inflammatory disease states and have been linked to spontaneous preterm birth and other adverse pregnancy outcomes. Recent advances in metagenomic research have proven that the placenta harbors its own rich diverse microbiome, even in clinically healthy pregnancies, and preterm birth may be a result of hematogenous infection rather than exclusively ascending infection as previously hypothesized. In this review, we describe the microbiome in healthy nongravid and gravid women to contrast it with the alterations of the microbiome associated with spontaneous preterm birth. We also discuss the importance of host gene-environment interactions and the potential for microbiota-specific targeted therapies to reduce the risk of adverse pregnancy outcomes.
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Affiliation(s)
- Chelsea Fox
- Department of Obstetrics and Gynecology, University of South Carolina-Greenville School of Medicine, Greenville Health Systems, Greenville, South Carolina
| | - Kacey Eichelberger
- Division of Maternal-Fetal Medicine, University of South Carolina-Greenville School of Medicine, Greenville Health Systems, Greenville, South Carolina.
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4
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Bass WT, DeLoach D, Khan JH, Green GA, Cunnion KM. Severe cystic periventricular leukomalacia in a premature infant with capnocytophaga sepsis. AJP Rep 2014; 4:e73-6. [PMID: 25452885 PMCID: PMC4239136 DOI: 10.1055/s-0034-1378147] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2014] [Accepted: 03/25/2014] [Indexed: 11/15/2022] Open
Abstract
Capnocytophaga is an opportunistic gram-negative anaerobic bacillus found in the oropharyngeal cavity of mammals and is associated with periodontal disease in humans. Sepsis, osteomyelitis, lung abscess, endocarditis, and meningitis have been reported in humans following animal bites. Perinatal infection with Capnocytophaga is infrequent and is generally considered to have a low risk of morbidity to the mother and fetus. We report a case of neonatal Capnocytophaga sepsis associated with the development of severe cystic periventricular leukomalacia.
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Affiliation(s)
- W Thomas Bass
- Department of Pediatrics, Division of Neonatal Medicine, Children's Hospital of The King's Daughters, Children's Specialty Group, Eastern Virginia Medical School, Norfolk, Virginia
| | - Donna DeLoach
- Department of Pediatrics, Division of Neonatal Medicine, Children's Hospital of The King's Daughters, Children's Specialty Group, Eastern Virginia Medical School, Norfolk, Virginia
| | - Jamil H Khan
- Department of Pediatrics, Division of Neonatal Medicine, Children's Hospital of The King's Daughters, Children's Specialty Group, Eastern Virginia Medical School, Norfolk, Virginia
| | - Glen A Green
- Department of Pediatrics, Division of Neonatal Medicine, Children's Hospital of The King's Daughters, Children's Specialty Group, Eastern Virginia Medical School, Norfolk, Virginia
| | - Kenji M Cunnion
- Department of Pediatrics, Department of Pediatric Infectious Disease, Children's Hospital of The King's Daughters, Children's Specialty Group, Eastern Virginia Medical School, Norfolk, Virginia
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5
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Gilbert SF. A holobiont birth narrative: the epigenetic transmission of the human microbiome. Front Genet 2014; 5:282. [PMID: 25191338 PMCID: PMC4137224 DOI: 10.3389/fgene.2014.00282] [Citation(s) in RCA: 70] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2014] [Accepted: 07/31/2014] [Indexed: 01/12/2023] Open
Abstract
This essay plans to explore, expand, and re-tell the human birth narrative. Usually, human birth narratives focus on the origins of a new individual, focusing on the mother and fetus. This essay discusses birth as the origin of a new community. For not only is the eukaryotic body being reproduced, but so also are the bodies of its symbiotic microbes and so is the set of relationships between these organic components. Several parts of the new narrative are surprising: (1) bacterial symbionts might cause some of the characteristics of pregnancy and prepare a symbiotic community for transfer; (2) the first bacterial colonizers of the mammalian organism my enter the fetus prior to the lysing of the amniotic membrane and birth; (3) the same signals that often cause immunological attack against a microbe may serve under these conditions to signal homeostatic stability between symbiont and host; and (4) the mother may actively provide substances that promote the growth and settlement of helpful bacteria. The birth of the holobiont exemplifies principles of co-evolution, co-development, niche construction, and scaffolding. Birth is nothing less than the passage from one set of symbiotic relationships to another.
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Affiliation(s)
- Scott F Gilbert
- Department of Biology, Swarthmore College Swarthmore, PA, USA ; Biotechnology Institute, University of Helsinki Helsinki, Finland
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6
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Lopez E, Raymond J, Patkai J, Ayoubl ME, Schmitz T, Moriette G, Jarreau PH. Capnocytophaga species and preterm birth: case series and review of the literature. Clin Microbiol Infect 2010. [DOI: 10.1111/j.1469-0691.2010.03151.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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7
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Howlett AA, Mailman TL, Ganapathy V. Early cystic lung disease in a premature neonate with perinatally acquired capnocytophaga. J Perinatol 2007; 27:68-70. [PMID: 17180135 DOI: 10.1038/sj.jp.7211627] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
We describe a premature infant with early cystic lung lesions and sepsis due to prenatally acquired Capnocytophaga infection. Early cystic lesions have not been described previously as a characteristic of this infection.
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Affiliation(s)
- A A Howlett
- Department of Pediatrics, Dalhousie University, Halifax, Nova Scotia, Canada.
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8
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Han YW, Ikegami A, Bissada NF, Herbst M, Redline RW, Ashmead GG. Transmission of an uncultivated Bergeyella strain from the oral cavity to amniotic fluid in a case of preterm birth. J Clin Microbiol 2006; 44:1475-83. [PMID: 16597879 PMCID: PMC1448680 DOI: 10.1128/jcm.44.4.1475-1483.2006] [Citation(s) in RCA: 114] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Intrauterine infection is a recognized cause of preterm birth. The infectious organisms are believed to originate primarily from the vaginal tract and secondarily from other parts of the body. It is plausible that microbes in the oral cavity can be transmitted to the pregnant uterus. However, direct evidence supporting such a transmission is lacking. In this study, amniotic fluids of 34 pregnant women were examined by PCR using 16S and 23S rRNA universally conserved primers. Bacterial DNA was amplified from the only patient with clinical intrauterine infection and histologic necrotizing acute and chronic chorioamnionitis. One strain, Bergeyella sp. clone AF14, was detected and was 99.7% identical to a previously reported uncultivated oral Bergeyella strain, clone AK152, at the 16S rRNA level. The same strain was detected in the subgingival plaque of the patient but not in her vaginal tract. The 16S-23S rRNA sequence of clone AF14 matched exactly with the sequences amplified from the patient's subgingival plaque. These observations suggest that the Bergeyella strain identified in the patient's intrauterine infection originated from the oral cavity. This is the first direct evidence of oral-utero microbial transmission. The patient's periodontal health during pregnancy was unclear. She did not have detectable periodontal disease during postpartum examination. Bergeyella spp. had not been previously associated with preterm birth and were detected in subgingival plaque of women without clinical levels of intrauterine infection. Uncultivated species may be overlooked opportunistic pathogens in preterm birth. This study sheds new light on the implication of oral bacteria in preterm birth.
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Affiliation(s)
- Yiping W Han
- Department of Biological Sciences, School of Dental Medicine, Case Western Reserve University, 10900 Euclid Avenue, Cleveland, OH 44106-4905, USA.
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Jeffcoat MK, Geurs NC, Reddy MS, Goldenberg RL, Hauth JC. Current evidence regarding periodontal disease as a risk factor in preterm birth. ANNALS OF PERIODONTOLOGY 2001; 6:183-8. [PMID: 11887462 DOI: 10.1902/annals.2001.6.1.183] [Citation(s) in RCA: 76] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Preterm birth, resulting in babies born too little and too soon, is a major cause of morbidity. Evidence indicates that infections can be major risk factors in preterm birth. Case-control studies point to an association between periodontal infection and increased rates of preterm birth. This paper summarizes evidence to date and the strategies that ongoing intervention studies are using to answer the fundamental clinical question: can periodontal therapy reduce the risk of preterm birth?
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Affiliation(s)
- M K Jeffcoat
- Department of Periodontology, UAB School of Dentistry, Birmingham, Alabama, USA.
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10
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Affiliation(s)
- R L Goldenberg
- Department of Obstetrics and Gynecology and the Center for Research on Women's Health, University of Alabama at Birmingham, 35233-7333, USA.
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11
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Douvier S, Neuwirth C, Filipuzzi L, Kisterman JP. Chorioamnionitis with intact membranes caused by Capnocytophaga sputigena. Eur J Obstet Gynecol Reprod Biol 1999; 83:109-12. [PMID: 10221619 DOI: 10.1016/s0301-2115(98)00240-1] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
We report a case of chorioamnionitis with intact membranes caused by Capnocytophaga sputigena. The pregnant woman was hospitalised in preterm labor without fever, neither tenderness, just regular contractions. In spite of the tocolitic treatment the patient gave birth to a girl at 29 weeks' gestation, weighing 1220 g and transferred to intensive care. The newborn had clinical and biological signs of infections and was initially treated by Ampicillin, cephalosporin and metronidazol. Capnocytophaga sputigena was found on membranes, cord, amniotic fluid and placenta. It was also identified in maternal endocervix culture. Histologic findings showed a focal chorioamnionitis. This was the fourteenth reported case of infection due to Capnocytophaga species occurring in pregnancy. All the cases are reviewed.
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Affiliation(s)
- S Douvier
- Department of Gynecology and Obstetrics, CHRU, Dijon, France
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12
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Abstract
Intraamniotic infection is a significant cause of perinatal morbidity. Capnocytophaga, a gram-negative anaerobe found in the oral cavity, has been implicated as an unusual cause of neonatal sepsis. We report a patient in whom this unusual organism was identified and describe the postpartum and neonatal courses.
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Affiliation(s)
- C Edwards
- Department of Obstetrics and Gynecology, Sinai Hospital, Baltimore, MD 21215, USA
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13
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Lopatin DE, Blackburn E. Avidity and titer of immunoglobulin G subclasses to Porphyromonas gingivalis in adult periodontitis patients. ORAL MICROBIOLOGY AND IMMUNOLOGY 1992; 7:332-7. [PMID: 1338600 DOI: 10.1111/j.1399-302x.1992.tb00632.x] [Citation(s) in RCA: 42] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
The relative avidity and titer of antibodies representing the 4 immunoglobulin G (IgG) subclasses (IgG1-4) reactive with Porphyromonas gingivalis, P. gingivalis-lipopolysaccharide (-LPS), streptokinase (SK) and tetanus toxoid (TT) in the sera of patients having adult periodontitis and of healthy controls were measured. Patient antibody titers to P. gingivalis and P. gingivalis-LPS were found to be significantly elevated for IgG, IgG1 (no P. gingivalis-LPS antibodies) and IgG2. The predominant antibody response to P. gingivalis and P. gingivalis-LPS occurred in the IgG2 subclass. When the relative avidity of the antibodies to P. gingivalis and P. gingivalis-LPS were examined, no significant differences between control and patient sera could be identified. However, anti-P. gingivalis and P. gingivalis-LPS antibodies were found to possess significantly lower relative avidity than either SK or TT antibodies. The IgG1 subclass antibodies to P. gingivalis, SK and TT all appeared to be of high relative avidity. In contrast, anti-P. gingivalis and P. gingivalis-LPS of the IgG2 subclass were of significantly lower relative avidity. Since the predominant humoral response to P. gingivalis occurs in the IgG2 subclass, the low relative avidity of these antibodies predominates in measurements of whole serum activity.
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Affiliation(s)
- D E Lopatin
- Department of Biological and Materials Sciences, School of Dentistry, University of Michigan, Ann Arbor
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14
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Roscoe DL, Zemcov SJ, Thornber D, Wise R, Clarke AM. Antimicrobial susceptibilities and beta-lactamase characterization of Capnocytophaga species. Antimicrob Agents Chemother 1992; 36:2197-200. [PMID: 1444299 PMCID: PMC245475 DOI: 10.1128/aac.36.10.2197] [Citation(s) in RCA: 61] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
Capnocytophaga species have been associated with a wide variety of infections in both immunocompetent and immunocompromised patients. On the basis of data from antimicrobial susceptibility studies, beta-lactam antibiotics have been considered efficacious therapy. Six of 19 isolates from primarily clinical sources across Canada demonstrated beta-lactamase production, and agar dilution susceptibility testing showed broad resistance to beta-lactam antibiotics. For the beta-lactamase producing isolates, clavulanate reduced the MIC of amoxicillin for 90% of the strains tested by 64-fold. Isolates were highly susceptible to clindamycin, imipenem, and ciprofloxacin. Characterization of the beta-lactamases produced by two of these isolates (Van1 and Van2) was performed. Isoelectric focusing revealed an identical isoelectric point of 5.6 for both enzymes, but they had markedly different relative hydrolysis efficiencies, and different conditions were required to extract the enzymes. This study demonstrates the production of different types of beta-lactamases by Capnocytophaga spp. and suggests the need to screen all clinical isolates of Capnocytophaga spp. for the presence of beta-lactamases.
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Affiliation(s)
- D L Roscoe
- Division of Medical Microbiology, St. Paul's Hospital, Vancouver, British Columbia, Canada
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15
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Sinnott JT, Cullison JP, Blanco PJ. Capnocytophaga. Infect Control Hosp Epidemiol 1988; 9:170-3. [PMID: 3361109 DOI: 10.1086/645824] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Capnocytophaga has been found to cause disease in the normal and the immunocompromised patient. Most often this organism is an opportunist that is difficult to isolate but easy to identify and a unique reminder that uncommon infection may respond to common antibiotics.
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Affiliation(s)
- J T Sinnott
- Division of Infectious and Tropical Diseases, University of South Florida CoM, Tampa
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McDonald H, Gordon DL. Capnocytophaga species: a cause of amniotic fluid infection and preterm labour. Pathology 1988; 20:74-6. [PMID: 3374977 DOI: 10.3109/00313028809085203] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Subclinical amniotic fluid infection and subsequent preterm labour may occur with intact membranes. We report two cases of subclinical amniotic fluid infection with intact membranes presenting in preterm labour. Capnocytophaga species, fastidious Gram-negative bacilli normally found in oral flora, were isolated in pure culture from amniotic fluid obtained by transabdominal amniocentesis. The distinctive microbiological features and spectrum of infections associated with Capnocytophaga species, and the importance of recognition of subclinical amniotic fluid infection as a cause of preterm labour, are discussed.
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Affiliation(s)
- H McDonald
- Department of Microbiology, Queen Victoria Hospital, Adelaide
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Paerregaard A, Gutschik E. Capnocytophaga bacteremia complicating premature delivery by cesarean section. EUROPEAN JOURNAL OF CLINICAL MICROBIOLOGY 1987; 6:580-1. [PMID: 3436319 DOI: 10.1007/bf02014253] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
A case of endomyometritis associated with Capnocytophaga ochracea bacteremia following premature delivery is described. The patient, a 30 year old woman without immunological incompetence or other predisposing disease, responded to peroral pivmecillinam. Capnocytophaga spp. should be considered a possible cause of post-partum endometritis.
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Affiliation(s)
- A Paerregaard
- Statens Seruminstitut, Department of Clinical Microbiology, Rigshospitalet, Denmark
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