A 24-year-old woman develops high-grade fever, foul-smelling brownish vaginal discharge, and hypotension two days after an unsafe induced abortion by an untrained provider. Blood film shows fragmented red cells and haemoglobinuria. Which organism is classically associated with this presentation?
- A Chlamydia trachomatis
- B Group B Streptococcus
- C Clostridium perfringens ✓
- D Treponema pallidum
Correct answer: C. Clostridium perfringens
Explanation
Septic abortion following unsafe procedures can be complicated by Clostridium perfringens bacteraemia. Its alpha toxin produces massive intravascular haemolysis with haemoglobinuria, bronze discolouration of discharge, DIC and acute renal failure, giving a very high mortality. Group B Streptococcus and Chlamydia cause genital tract infection but not intravascular haemolysis. Treponema pallidum causes syphilis and is unrelated to post-abortal sepsis. Management needs broad antibiotics, resuscitation and prompt uterine evacuation.
Reference: DC Dutta's Textbook of Gynecology, 9th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
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