Case of the Month - April 2022
A 21-year-old G1P0 woman presented to the Emergency Room in the 11th week of her pregnancy with two days fevers to 100.9oF. She also had one day of crampy lower abdominal and pelvic pain with a yellow vaginal discharge and vaginal bleeding.
On physical exam, her pulse was in the 120s and she was hypotensive. Her pelvic exam was significant for cervical motion tenderness and watery discharge mixed with blood in the vaginal vault. Her white blood cell count was 17K/uL. She underwent an emergent dilation and curettage and was started on IV ampicillin, gentamicin, and clindamycin for a septic abortion. Blood and genital cultures were obtained.
Gram stain of the blood culture revealed Gram-negative coccobacilli (Figure 1). There was no growth on the blood agar plate. However, multiple smooth, grey, opaque colonies were identified on the chocolate agar plate (Figure 2). The organism was catalase and oxidase positive. Growth was seen surrounding the X factor (hemin) and V factor (nicotinamide adenine dinucleotide) disk.
Name the bacteria that caused the patient’s septic abortion
