FATAL SEPSIS DUE TO ESCHERICHIA-COLI AFTER 2ND-TRIMESTER AMNIOCENTESIS

The case of a pregnant woman (16th week) needing an amniocentesis is r eported. She rapidly developed a septic shock. Despite vaginal deliver y, curettage and antibiotherapy, the patient deteriorated with the ons et of an acute respiratory distress syndrome and a typical disseminate d intravascular coagulation. Bacteriological data showed positive bloo d cultures to Escherichia coli. Amniotic liquid was positive to the sa me E. coli. Cultures obtained from instruments, disinfectant solutions and gel used during the procedure were negative. On the contrary, amn iotic and fetal cultures were positive to E. coli and Clostridium perf ringens. She died 2 days later. The incidence of septic shock followin g amniocentesis is very low but we report the first case of fatal seps is and multiorgan failure, due to E. coli and C. perfringens. The mech anisms of infection are discussed: contamination from the instruments, systemic dissemination of bacteria coming from an asymptomatic intra- amniotic infection, and inoculation of the placenta with a needle pass ing through the bowel.