A woman undergoes an unsafe induced abortion by an untrained practitioner. Three days later she presents with high fever, foul-smelling serosanguinous discharge, hypotension, tachycardia, and marked uterine tenderness. Peripheral smear shows red cell fragments and haemoglobinuria is noted. Which organism is most likely responsible?

• A Escherichia coli
• B Clostridium perfringens ✓
• C Group B Streptococcus
• D Mycoplasma hominis

Explanation

Clostridium perfringens (welchii) is the classic organism of septic abortion complicated by gas gangrene. Its alpha toxin (phospholipase B) destroys red cell membranes, causing massive intravascular haemolysis, haemoglobinuria, and acute renal failure. The combination of fever, foul discharge, shock, and haemolysis after an unsafe abortion points directly to it. Escherichia coli and other gram-negative organisms cause endometritis and septic shock but not the haemolytic picture, while Mycoplasma hominis and Group C Streptococcus produce milder genital tract infection without intravascular haemolysis.

Reference: DC Dutta's Textbook of Obstetrics, 10th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

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