European Journal of Obstetrics & Gynecoiogv and Reproductive
91
Biology, 31 (1990) 91-94
Els&icr EUROBS 00976
Pregnancy complicated by severe Chlamydia psittaci infection acquired from a goat flock: a case report P. Villemonteix
‘, G. Agius 2, B. Ducroz ‘, J. Rouffineau M. Castets ’ and G. Maguin’
3, V. Plocoste
i,
’ Service de Gynkologie-ObstPtrique, 2 Laboratoire de Microbiologic B, and ’ Service de R&animation Chirurgicale, Centre Hospitalier La MiMtrie, Poitiers, France Accepted for publication 8 November 1989 Pregnancy; Infection; Goat flock; C. psittaci
Case report
A 26-year-old farmer’s wife, in the 32nd week of her second pregnancy, presented with a temperature of 38.5’C, cough and headache. She had been treated at home with amoxicillin for 2 days, without benefit. She was admitted to the hospital on 4 May 1988, presenting with a premature labour and a quick delivery (1 hour) of a stillborn boy, weighing 1800 g, dead per partum. Six hours after admission, her temperature rose to 39.5” C and she developed acute adult respiratory distress syndrome. The chest radiogram showed bilateral and basal pulmonary oedema. Blood pressure was 60 mmHg. The oxygen pressure was 5.4 kPa, and the pulmonary capillary wedge pressure was 1.2 kPa at the intensive care unit (ICU). Continuous positive airways pressure without intubation was initiated. The blood creatinine value was 406 pmol/l, haemoglobin level 6.0 g/dl, haematocrit value 20%, bilirubin level 78.7 pmol/l, and the platelet count was 20.0 - 109/1. Fibrin degradation products at 80 mg/l (normal range less than 10 mg/l) and anti-platelet antibodies with a titer of 9720 in specific total immunoglobulins (IgT) were present. Acute pneumonitis, and renal, respiratory and circulatory failures associated with an haemolytic anaemia, and a disseminated intravascular coagulation with purpura were diagnosed. She responded well to intravenous amoxicillin, clavulanic acid, gentamicin and spiramycin. On 10 May 1988, the pulmonary, renal, hepatic and haematological functions returned to normal, and the patient was discharged from the ICU. A follow-up of 6 months was uneventful. Bacteriological cultures from blood, urine, stools, cervix, placental and fetal tissues were negative. No virus or Chlamydia isolations were performed. A compleCorrespondence: P. Villemonteix, Chef de Clinique, Service de Gyn&zologie, Obsdtrique Tour&), CHR La Mil&rie, B.P. 577,86021 Poitiers Cedex, France. 0028-2243/90/$03.50
8 1990 Elsevier Science Publishers B.V. (Biomedical Division)
(Pr. H. de
92 TABLE I Chlamydia psittaci ovine strains Dates
05-05-88 19-05-88
and Chlamydia
trachomatis
titers by CFT and IFA using antigens
CFT C. psittacci
IFA C. psittacci
avian
ovine
avian
20 160
40 160
from avian and
IFA C. trachomatis ovine
IgT
IgM
IgT
IgM
32 2048
C6 24
16 2048
(6 24
IgT
IgM
32 2048
91
Biology, 31 (1990) 91-94
Els&icr EUROBS 00976
Pregnancy complicated by severe Chlamydia psittaci infection acquired from a goat flock: a case report P. Villemonteix
‘, G. Agius 2, B. Ducroz ‘, J. Rouffineau M. Castets ’ and G. Maguin’
3, V. Plocoste
i,
’ Service de Gynkologie-ObstPtrique, 2 Laboratoire de Microbiologic B, and ’ Service de R&animation Chirurgicale, Centre Hospitalier La MiMtrie, Poitiers, France Accepted for publication 8 November 1989 Pregnancy; Infection; Goat flock; C. psittaci
Case report
A 26-year-old farmer’s wife, in the 32nd week of her second pregnancy, presented with a temperature of 38.5’C, cough and headache. She had been treated at home with amoxicillin for 2 days, without benefit. She was admitted to the hospital on 4 May 1988, presenting with a premature labour and a quick delivery (1 hour) of a stillborn boy, weighing 1800 g, dead per partum. Six hours after admission, her temperature rose to 39.5” C and she developed acute adult respiratory distress syndrome. The chest radiogram showed bilateral and basal pulmonary oedema. Blood pressure was 60 mmHg. The oxygen pressure was 5.4 kPa, and the pulmonary capillary wedge pressure was 1.2 kPa at the intensive care unit (ICU). Continuous positive airways pressure without intubation was initiated. The blood creatinine value was 406 pmol/l, haemoglobin level 6.0 g/dl, haematocrit value 20%, bilirubin level 78.7 pmol/l, and the platelet count was 20.0 - 109/1. Fibrin degradation products at 80 mg/l (normal range less than 10 mg/l) and anti-platelet antibodies with a titer of 9720 in specific total immunoglobulins (IgT) were present. Acute pneumonitis, and renal, respiratory and circulatory failures associated with an haemolytic anaemia, and a disseminated intravascular coagulation with purpura were diagnosed. She responded well to intravenous amoxicillin, clavulanic acid, gentamicin and spiramycin. On 10 May 1988, the pulmonary, renal, hepatic and haematological functions returned to normal, and the patient was discharged from the ICU. A follow-up of 6 months was uneventful. Bacteriological cultures from blood, urine, stools, cervix, placental and fetal tissues were negative. No virus or Chlamydia isolations were performed. A compleCorrespondence: P. Villemonteix, Chef de Clinique, Service de Gyn&zologie, Obsdtrique Tour&), CHR La Mil&rie, B.P. 577,86021 Poitiers Cedex, France. 0028-2243/90/$03.50
8 1990 Elsevier Science Publishers B.V. (Biomedical Division)
(Pr. H. de
92 TABLE I Chlamydia psittaci ovine strains Dates
05-05-88 19-05-88
and Chlamydia
trachomatis
titers by CFT and IFA using antigens
CFT C. psittacci
IFA C. psittacci
avian
ovine
avian
20 160
40 160
from avian and
IFA C. trachomatis ovine
IgT
IgM
IgT
IgM
32 2048
C6 24
16 2048
(6 24
IgT
IgM
32 2048
