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ERYSIPELAS IN PREGNANCY: Title and subTitle BreakREPORT OF A CASE WITH FATAL OUTCOME FREE

Harry N. Jurow, M.D.; Rosemary Clark, M.D.
[+] Author Affiliations

San Francisco

From the departments of obstetrics and gynecology and pathology, Mount Zion Hospital and Medical Center.


JAMA. 1959;170(11):1299-1302. doi:10.1001/jama.1959.03010110047009
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Information on the association of erysipelas with pregnancy is rare. A 32-year-old woman, para 3, gravida 7, six weeks before her expected date of delivery noted a slight swelling over the right cheek. It persisted, and she was treated with ACTH and diphenhydramine hydrochloride. Several days later she was hospitalized with edema, erythema, induration of the face and neck, and a temperature of 38.6 C (101.5 F). Chlortetracycline and meperidine hydrochloride were included in therapy. Cultures disclosed hemolytic streptococci. The disease process extended to the upper one-fourth of the chest, and therapy with erythromycin was started. A living girl in good condition was delivered. Several hours later blood pressure had dropped to 84/70 mm. Hg. Whole blood, hydrocortisone, lanatoside C, streptomycin, and levarterenol bitartrate were given, but the patient became cyanotic and died. The anatomic diagnosis was erysipelas with acute cellulitis of the face, neck, and chest; acute mediastinitis involving the pericardium and pleurae with pleural effusion; and acute congestion of the viscera. Pregnancy undoubtedly was a factor in the outcome.

REFERENCES

Siegmund, H.:  Atypisches Erysipel und Schwangersshaft , Zentralbl. f. Gynäk. 51:2787-2792 ( (Oct. 29) ) 1927;.
Lubin, S.:  Erysipelas Complicating Labor at Term , Am. J. Surg. 35:131-134 ( (Jan.) ) 1937;.
Keefer, C. S., and Spink, W. W.:  Studies of Hemolytic Streptococcal Infection: Factors Influencing Outcome of Erysipelas , J. Clin. Investigation 15:17-19 ( (Jan.) ) 1936;.
Hoyne, A. L.; Wolf, A. A.; and Prim, L.:  Fatality Rates in Treatment of 998 Erysipelas Patients: Influence of Sulfonamide , J. A. M. A. 113:2279-2281 ( (Dec. 23) ) 1939;.
Snodgrass, W. R.; Anderson, T.; and Rennie, J. L.:  Sulphamido-Chrysoidine, Sulphanilamide, and Benzyl-Sulphanilamide in Treatment of Erysipelas: Controlled Series of 242 Cases , Brit. M. J. 2:399-403 ( (Aug. 20) ) 1938;.
Williams, W.: Obstetrics , New York, D. Appleton & Co., 1930;, p. 588.
Obstetric Medicine: Diagnosis and Management of Commoner Diseases in Relation to Pregnancy , edited by F. L. Adair and E. J. Steiglitz, Philadelphia, Lea & Febiger, 1934;, p. 207.
De Lee, J. B.: Principles and Practice of Obstetrics , ed. 5, Philadelphia, W. B. Saunders Company, 1928;, p. 493.
Hynes, M., and Whitby, L. E. H.:  Correction of Sedimentation-Rate for Anaemia , Lancet 2:249-251 ( (July 30) ) 1938;.
Mortensen, O.:  Efficacy of Penicillin and 2-Sulfonilamide-5-Methyl-1,3,4, Thiodiazole ("Lucosil") in Treatment of Erysipelas: Comparative Study of 150 Cases , Acta med. scandinav. 139:465-471, 1951;.
Schembra, F. W.:  Die Behandlung des Erysipels , Deutsche med. Wchnschr. 80:1093-1094 ( (July 22) ) 1955;.
Griffith, R. S.: Blood Levels and Clinical Results with Erythromycin, Antibiotics Annual 1954-1955 , New York, Medical Encyclopedia, Inc., 1955;, pp. 269-278.
Welsh, A. L., in Current Therapy 1956: Latest Approved Methods of Treatment for Practicing Physicians , edited by H. F. Conn, Philadelphia, W. B. Saunders Company, 1956;, p. 396.

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Siegmund, H.:  Atypisches Erysipel und Schwangersshaft , Zentralbl. f. Gynäk. 51:2787-2792 ( (Oct. 29) ) 1927;.
Lubin, S.:  Erysipelas Complicating Labor at Term , Am. J. Surg. 35:131-134 ( (Jan.) ) 1937;.
Keefer, C. S., and Spink, W. W.:  Studies of Hemolytic Streptococcal Infection: Factors Influencing Outcome of Erysipelas , J. Clin. Investigation 15:17-19 ( (Jan.) ) 1936;.
Hoyne, A. L.; Wolf, A. A.; and Prim, L.:  Fatality Rates in Treatment of 998 Erysipelas Patients: Influence of Sulfonamide , J. A. M. A. 113:2279-2281 ( (Dec. 23) ) 1939;.
Snodgrass, W. R.; Anderson, T.; and Rennie, J. L.:  Sulphamido-Chrysoidine, Sulphanilamide, and Benzyl-Sulphanilamide in Treatment of Erysipelas: Controlled Series of 242 Cases , Brit. M. J. 2:399-403 ( (Aug. 20) ) 1938;.
Williams, W.: Obstetrics , New York, D. Appleton & Co., 1930;, p. 588.
Obstetric Medicine: Diagnosis and Management of Commoner Diseases in Relation to Pregnancy , edited by F. L. Adair and E. J. Steiglitz, Philadelphia, Lea & Febiger, 1934;, p. 207.
De Lee, J. B.: Principles and Practice of Obstetrics , ed. 5, Philadelphia, W. B. Saunders Company, 1928;, p. 493.
Hynes, M., and Whitby, L. E. H.:  Correction of Sedimentation-Rate for Anaemia , Lancet 2:249-251 ( (July 30) ) 1938;.
Mortensen, O.:  Efficacy of Penicillin and 2-Sulfonilamide-5-Methyl-1,3,4, Thiodiazole ("Lucosil") in Treatment of Erysipelas: Comparative Study of 150 Cases , Acta med. scandinav. 139:465-471, 1951;.
Schembra, F. W.:  Die Behandlung des Erysipels , Deutsche med. Wchnschr. 80:1093-1094 ( (July 22) ) 1955;.
Griffith, R. S.: Blood Levels and Clinical Results with Erythromycin, Antibiotics Annual 1954-1955 , New York, Medical Encyclopedia, Inc., 1955;, pp. 269-278.
Welsh, A. L., in Current Therapy 1956: Latest Approved Methods of Treatment for Practicing Physicians , edited by H. F. Conn, Philadelphia, W. B. Saunders Company, 1956;, p. 396.
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