Clostridium sordelli toxic shock after endometrial ablation: Review of gynecologic cases

Background: Clostridium sordelli is a rare toxin-mediated infection that has been associated with profound septic shock and a nearly 100% mortality rate in obstetric and gynecologic patients. Case: A 45-year-old female presented with pyometra after a NovaSure® ablation. She became progressively septic after an initial presentation of abdominal pain, leukocytosis, hemoconcentration, and diarrhea. She underwent exploratory laparotomy, total abdominal hysterectomy, and bilateral salpingo-oophorectomy. Tissue cultures were positive for Enterococcus faecalis and C. sordelli. She developed rapid septic shock and acute respiratory distress syndrome, requiring extracorporeal membrane oxygenation. Results: She subsequently had a complete recovery after her sepsis was treated. Conclusions: This is the first report to describe C. sordelli-associated septic shock in a patient who underwent an endometrial ablation. This is also the first case reported of survival of a Clostridium sordelli infection after a gynecologic procedure.