Title : Near miss case presented with toxic shock syndrome
Abstract:
A 24 years, P-1, lady underwent dilatation, evacuation and curettage for incomplete abortion for her 2nd pregnancy loss at +10 weeks of gestation in a rural setup. She was given IUCD following the procedure as long acting reversible contraceptive method at the same sitting.
After 48 hours she was transferred to our tertiary care centre due to septic shock.
She had H/O, recurrant UTI before and during pregnancy and was treated by antibiotics inadvertently for several occasions.
She developed fever and diarrhoea next day and had hypotention after 48 hours.
On admission, she had a temperature of 101?F, tachycardia, hypotention and SPO2 was 90%. Per speculum examination revealed, parous cervical os with scanty foul smelling blood stained discharge and Cu-T thread seen, which was removed.
She was resuscitated and managed in ICU, her blood culture grew staphylococcus aureus while cervical vaginal swab and urine cultures were negative.
She initially received injection Ceftriaxone and Metronidazole for 48 hours and later on injection Cefuroxime for which staph.aureus was sensetive.
She recovered after a week and was discharged on day 23 of admission.
Audience Take Away:
- The presentation is a bit unusual, the patient had recurrant urinary tract infection which might be the predisposing factor for the abortion and later on development of TSS soon after insertion of IUCD following evacuation, I am sure, the audience will be able to use my experience in their daily practice.
- How will this help the audience in their job? As this is a rare but life threatening condition, prompt diagnosis and immediate management is utmost important for the life saving purpose. So the audience could be able to save such near miss cases.
- Is this research that other faculty could use to expand their research or teaching? Yes, certainly they can use.
- Does this provide a practical solution to a problem that could simplify or make a designer’s job more efficient? Yes, I hope so.
- Will it improve the accuracy of a design, or provide new information to assist in a design problem? In my opinion, it will improve but further research and more study is required to provide more new information.
- List all other benefits. Low resource countries, where septicemia due to abortion and other post partum infection is more common and the second cause of maternal mortality could be benefitted and able to reduce maternal mortality significantly.
