Women of childbearing age may be at risk for clostridium-associated toxic shock

Although uncommon in the general population, about 1 in 200 deaths of women of childbearing age in California is because of Clostridium sordellii toxic shock (CSTS), according to the findings of a recent population-based death certificate review study.

The authors of the study reported that of 38 women ranging in age from 32 to 41 years who were suspected of having C sordellii-associated deaths based on death certificate ICD-10 diagnoses, 5 tested positive for Clostridium species: 3 for Clostridium perfringens, 1 for C sordellii, and 1 for both.

Two of the deaths occurred after medical procedures for cervical dysplasia (1 for conization and 1 for laser therapy); 1 occurred after an abortion using cervical dilatation with laminaria followed by curettage; 1 occurred after a stillborn delivery; and 1 occurred 4 days after a term live birth.

Ho CS, Bhatnagar J, Cohen AL, et al. Undiagnosed cases of fatal Clostridium-associated toxic shock in Californian women of childbearing age. Am J Obstet Gynecol. 2009;201(5):459.e1-e7.