Q: 26 year old female with recent history of abortion presented with hypotension, fever and severe abdominal pain. OB/Gyn service ordered intravenous urogram. Following abdominal film is obtained?
Answer: Uterine gas gangrene
Anaerobic infections with Clostridium perfringens (CP) occur rarely but are associated with considerable maternal mortality. Targeted antibiotics should be started ASAP. Surgery backup should be called to perform a hysterectomy and necrosis removal. Clostridium perfringens is ubiquitous and is found vaginally in 1 - 10 % of healthy women and usually does not cause a serious infection. Under the right conditions it can cause an endometritis leading to sepsis. Early recognition and interdisciplinary treatment are of extreme importance.
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