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Chorioamnionitis caused by Serratia marcescens in a non-immunocompromised host
  1. S Shimizu1,
  2. H Kojima1,
  3. C Yoshida1,
  4. K Suzukawa1,
  5. H Y Mukai1,
  6. Y Hasegawa1,
  7. S Hitomi2,
  8. T Nagasawa1
  1. 1Division of Haematology, Infectious Disease, Institute of Clinical Medicine, University of Tsukuba Tsukuba, Ibaraki, 305-8575, Japan
  2. 2Infectious Disease, Institute of Clinical Medicine, University of Tsukuba
  1. Correspondence to:
 Dr H Kojima
 Division of Haematology, Institute of Clinical Medicine, University of Tsukuba, Tsukuba, Ibaraki, 305-8575, Japan;


A 26 year old pregnant woman with antithrombin III deficiency developed recurrent septicaemia with Serratia marcescens. In spite of the administration of antibiotics, high grade fever persisted. She subsequently manifested lower abdominal pain, and spontaneous abortion occurred. After the abortion, she became completely afebrile. The amnion was turbid, and microscopic examination of the placenta showed haemorrhage and massive infiltration of neutrophils, suggestive of infectious chorioamnionitis. Pulsed field gel electrophoresis showed that isolates from the blood, urine, and vaginal discharge were genetically identical. Intravenous pyelography revealed that she had a bilateral completed double ureter. It was thought that a urinary tract anomaly caused infection with S marcescens, and the pathogen spread to the chorioamnion via the bloodstream. This is the first report of chorioamnionitis caused by S marcescens in a non-immunocompromised host. In addition, these findings indicate that the chorioamnion can serve as a site for persistent infection in normal pregnancies.

  • Chorioamnionitis
  • Serratia marcescens
  • sepsis
  • AT III, antithrombin III
  • CAZ, ceftazidime
  • DVD, deep vein thrombosis
  • IPM/CS, imipenem/cilastatin
  • MIC, minimum inhibitory concentration
  • PFGE, pulsed field gel electrophoresis

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