Septic Abortion with Initial Presentation Mimicking Meningitis

初期疑似腦膜炎之敗血性流產個案

潘志祥(Chee-Seong Phan) ； 吳肇鑫(Chao-Hsin Wu) ； 陳永福(Ying-Hock Teng)

《中華民國急救加護醫學會雜誌》 21卷3期 (2010/09) Pp. 142-146

https://doi.org/10.30018/JECCM.201009.0003

摘要

敗血性流產是造成孕婦死亡的常見原因，臨床表徵呈現多樣化。本文報告一名三十五歲的轉診個案，主要有意識不清、高燒、頸部僵硬等問題，初步診斷為疑似腦膜炎，但是會診婦產科醫師後，發現該名患婦的主要病因是敗血性流產。經驗不足的醫師容易將轉診個案的診斷掉入先入為主的陷阱，以為泌尿道感染造成敗血性休克或者是呼吸道感染造成腦膜炎，因而忽略其他科別的問題。個案經治療後，存活且康復出院。我們建議年輕女性個案若出現發燒、休克等症狀，應將婦科問題列入鑑別診斷。

關鍵字

敗血性流產 ； 敗血性休克 ； 腦膜炎

並列摘要

Septic abortion is a common cause of maternal death that demonstrates many varied clinical conditions. It can be mistaken for septic shock due to urinary tract infection or meningitis due to respiratory tract infection, with neglect of other possible gynecological causes. Herein, we reported a 35-year-old pregnant woman with unclear consciousness, high fever, and neck stiffness; her preliminary diagnosis was meningitis. We consulted with gynecologist and then found out her major etiology was septic abortion. This patient was discharged without any morbidity. We suggest that gynecological causes should be included in the differential diagnosis in young females with fever and shock.

並列關鍵字

septic abortion ； septic shock ； meningitis