Urinary Tract Infections (Jack D. Sobel, Section Editor)

Current Infectious Disease Reports

, Volume 13, Issue 6, pp 561-570

First online:

Gynecologic Clostridial Toxic Shock in Women of Reproductive Age

  • Suzanne ZaneAffiliated withDivision of Reproductive Health, Centers for Disease Control and Prevention Email author 
  • , Jeannette GuarnerAffiliated withDepartment of Pathology and Laboratory Medicine, Emory University School of Medicine, Emory University Hospital

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Clostridial toxic shock, caused by Clostridium sordellii or Clostridium perfringens, is a rare and largely fatal syndrome among reproductive-aged women with genital tract infection, and may occur following various pregnancy outcomes or without pregnancy. Clinicians should be aware of common clinical features of this very rapidly-progressing syndrome including abdominal pain, tachycardia, hypotension, third-space fluid accumulations, hemoconcentration, and marked leukemoid response, often with lack of fever. In this review, we summarize known cases through mid-2011 and information on clinical presentation, diagnosis, treatment, and results of recent investigations regarding pathogenesis, including germination, toxins, and host response that may have important implications for development of preventive or therapeutic interventions.


Clostridium Toxic shock Endometritis Myometritis Pregnancy Abortion Mifepristone Leukemoid Toxins Lethal toxin Clostridium sordellii Clostridium perfringens Gynecologic Obstetric Molecular diagnosis Pathogeneses