Toxic Shock Syndrome, Clostridium sordellii

C sordellii is a rare cause of endometritis and toxic shock syndrome following childbirth

Fatal cases of uterine infection following medically induced abortion with mifepristone have been reported

Abdominal pain

Absence of fever

Onset of illness was within 4–5 days of ingestion of mifepristone

Clinical course is fulminant

Infection appeared to be limited to the uterus, which shows

• Necrosis

• Edema

• Hemorrhage

• Acute inflammatory changes

Tachycardia, severe hypotension, capillary leak syndrome with edema

Profound leukocytosis, hemoconcentration

Early recognition

Aggressive resuscitation from shock

Immediate surgical debridement with hysterectomy

Administration of an antimicrobial active against C sordellii, including

• Penicillin

• Ampicillin

• Macrolide

• Clindamycin

• Tetracycline

• Metronidazole