Peripartum Bacteremias Due to Leptotrichia amnionii and Sneathia sanguinegens , Rare Causes of Fever during and after Delivery

Abstract

We report three cases of delivery and postpartum bacteremia due to unusual anaerobic bacteria in healthy young women. Leptotrichia amnionii bacteremia occurred during delivery in two mothers and was associated with fetal distress during labor. Conversely, Sneathia sanguinegens bacteremia occurred postpartum, 2 days after delivery, without consequence for the neonate. CASE REPORTS Case 1.A 36-year-old woman from North Africa who was living in France had a pregnancy without complications. Vaginal delivery was associated with fetal distress during labor (acidosis, abnormal cardiac rhythm, and colored amniotic liquid), and a maternal postpartum fever up to 39°C occurred rapidly 1 h after delivery. Three blood cultures from peripheral veins were obtained after delivery but before any antibiotic administration. Each blood culture consisted of a pair of BACTEC PLUS Aerobic/F and Anaerobic/F culture vials (BD, Meylan, France). After blood cultures were obtained, the patient was treated with intravenous antibiotic therapy. One gram of intravenous amoxicillin was administered three times per day. Within 10 days of antibiotic therapy, the patient had recovered completely. The newborn did not develop postnatal clinical or laboratory evidence of infection despite initial fetal distress during labor.Case 2. A 32-year-old woman from Turkey who was living in France had a pregnancy without complications. Vaginal delivery was as described above for case 1, and a maternal postpartum fever up to 39°C occurred rapidly 1 h after delivery. Three blood cultures from peripheral veins were obtained after delivery but before any antibiotic administration. Each blood culture consisted of a pair of BACTEC PLUS Aerobic/F and Anaerobic/F culture vials. After blood cultures were obtained, the patient was treated with intravenous antibiotic therapy. One gram of intravenous amoxicillin was administered three times per day. However, because of fever relapse, clavulanic acid was added on the third day. On day 6, this patient developed another febrile episode, while her white blood cell count and C-reactive protein levels were normal and additional blood cultures remained negative. Within 10 days of antibiotic therapy, the patient had recovered completely. The newborn did not develop postnatal clinical or laboratory evidence of infection despite initial fetal distress during labor.Case 3. A 21-year-old woman from Turkey who was living in France had a pregnancy without complications. Vaginal delivery was without fetal distress, but the patient presented with fever up to 39°C 2 days after delivery. Three blood cultures from peripheral veins were obtained after delivery but before any antibiotic administration. Each blood culture consisted of a pair of BACTEC PLUS Aerobic/F and Anaerobic/F culture vials. After blood cultures were obtained, the patient was treated intravenously with 1 g of amoxicillin-clavulanic acid three times per day, 500 mg of metronidazole two times per day, and 100 mg of netilmicin two times per day for 4 days, which was then sw...

16S rRNA Gene Sequencing in Routine Identification of Anaerobic Bacteria Isolated from Blood Cultures

“…The identification of Sneathia sanguinegens and Solobacterium moorei are good examples of the importance of species identification with prompt recognition of the primary site of infection (17). Sneathia sanguinegens (female genital tract) was isolated from a patient with postpartum fever, and Solobacterium moorei (oral cavity) from a patient with a dental abscess (5,9). The recognition of contaminants is also important to avoid unnecessary diagnostic testing.…”

Acute Myelogenous Leukemia with <i>Leptotrichia trevisanii</i> Bacteremia

“…After excluding two cases for which insufficient clinical information was provided, we investigated the clinical findings of the remaining 33 cases and our patient [34 cases in total; Table 2 (3,4,(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)]. The patients' ages ranged from three to 84 years (mean: 43.7 years), and there were 17 men and 17 women.…”

Septic arthritis due to a Sneathia species most closely related to Sneathia sanguinegens

“…Identification of S. sanguinegens species was obtained by the cloning and sequencing of the 16S rRNA gene. Ten previous cases of S. sanguinegens have been reported in the literature, five cases of delivery and post-partum bacteraemia, two cases of neonatal bacteraemia, two cases of bacteraemia in non-obstetric patients, and one amnioticfluid infection (Collins et al, 2001;Hanff et al, 1995;De Martino et al, 2004).…”