After the birth, a streptococcal infection almost killed me too



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But back in the house, he hit me with another wave of chills. I took ibuprofen and wandered to the deck to warm up under the hot July sun. But as he listened to the birds in the pines, he trembled violently and uncontrollably. It was time to go back to the hospital.

There, my fever soared to 104. The nurses spread three warm blankets over me and left me alone. Pain roared in my back. It felt as bad as delivery, and I writhed on the bed. An hour later, I was connected to an IV and a nurse came to take my vital signs. There was a loud beep and a burst, and the nurse rushed to put on an oxygen mask. My pulse was 210. It was then, lying on that hospital bed with the lights low, that I thought I might die.

For the next two days, my fever came and went, and the doctors determined that I had sepsis. I was injected with three types of antibiotics while trying to find out what kind of bacteria was causing the blood infection. While we waited, I began to feel pain in my right lung when I breathed. Two days after registering and nine days after giving birth, the results came back and the news was scary: I was infected with group A streptococci, one of the organisms that can cause diseases that eat meat.

The Centers for Disease Control and Prevention estimates that there were 18,700 cases of group A invasive streptococci in 2016. Nearly 10 percent of those people died.

Group A Streptococcus bacteria can be mild and easy to treat, such as when they cause strep throat and live on the skin without causing symptoms But once it spreads to the body through the skin, throat and In other places, it is a "remarkably aggressive organism," says Stan Deresinski, a specialist in infectious diseases at Stanford Health Care. It releases toxins that can cause streptococcal toxic shock syndrome, destroy tissue and cause organ failure and death.

If the bacteria penetrate under the skin, it can move rapidly along the connective tissue, destroying the skin, fat and tissue covering the muscles, and causing necrotizing fasciitis or infection from eating meat. To stop the spreading damage, doctors remove the dead tissue, in a process called debridement, and sometimes a complete limb must be amputated.

Each year between 600 and 1,100 cases of necrotizing fascitis due to group A streptococcus occur in the United States, according to the CDC.

After telling me what the exams found, my doctor sat on the edge of my bed. She said that my liver enzymes were high and were increasing, the first signs of shock. She told me that to stop the infection, I had to get rid of its source. In other words, I would need a hysterectomy. Surgery was also the way to find out if he had necrotizing fasciitis. She had no symptoms in the womb, the doctors were acting on a well-informed hunch since she had just given birth.

"We can not wait 48 hours, we can not wait 24 hours," he said. "You need surgery now."

He told me that they had seen this before: a case in which a woman suffered from group A streptococcus but did not have symptoms in the uterus. By the way he said it, he could say that the other woman died. (He later confirmed that.)

My doctor looked at me closely and said in a low voice: "You have to be here for your children."

This is where I feel lucky: I was in a hospital with experienced and proactive doctors. Less than an hour after that conversation with my doctor, I entered an operating room. I did not have time to process the enormity of everything. Later, the surgeon told my husband that my uterus was so infected that when he went to remove it, it was crushed. But he understood everything, and there were no signs that necrotizing fasciitis had seized.

And then my fever disappeared, simple as that.

After four more days in the hospital, I was sent home with IV to take antibiotics for another week.

In the next few weeks, I asked each doctor that I saw how and where I had contracted the infection. Not only am I healthy, but I was also a football player in college. I've run marathons. I am fit, and like a diet mainly vegetarian. What could I have done differently?

Everyone had the same answer: they did not know.

My doctor tells me that I am the only person she knows may have contracted the infection while I was in the hospital after giving birth. The doctors had seen other cases, including the woman who died, and all had been transported from other hospitals, rural areas and, in one case, a home birth.

Women who are at the time of delivery are particularly vulnerable to infections because it is "easy for the body to invade [by using] breaks in the epidermal / mucosal barriers in the bad and vulva," says Deresinski. In addition, a woman's immunity can be "somewhat depressed" during pregnancy, he added.

In my case, my doctors broke my water by piercing my amniotic sac to speed up labor. That may provide a pathway for the bacteria, and I had a second-degree break in my perineum during delivery. In every 100,000 live births, six women will contract group A invasive streptococci, according to the CDC, and most of these cases occur after a badl delivery.

In addition, contact with young children is an "underestimated risk factor" for contracting an invasive group A streptococcus, according to CDC medical epidemiologist Chris Van Beneden, an expert on these infections, because the 25th 100 percent of children carry the bacteria in their throat compared to less than 5 percent of adults. "This was probably the result of at least two factors: widespread contact with other children in day care and other places, and an immune system that is not as mature as in older people," Deresinski said. I had a 4 year old boy and a 2 year old boy at home.

There is one thing you could have done.

During a prenatal visit when I was about 32 weeks pregnant, I had a persistent throat ulcer. The nurses threw a light in my throat and saw a white spot on the right side. My doctor took a culture and prescribed antibiotics if I had positive results for streptococcal pharyngitis. The next day, the culture was negative, so the nurse and I agreed that I did not need to take the antibiotics. It may not have made any difference, but in retrospect, I wish I had taken the medication.

Now, a year later, I am completely healthy, as is my son.

And when I read stories about women who suffered -or died- after giving birth, as that woman did in Nova Scotia, I am overwhelmed with emotion. It pinches me: I'm so grateful to be here and I can support my little ones.

When my doctor sat in my hospital bed to tell me I needed surgery right away, he thought I would not do it another day without the infection consuming my body.

Today, I look back with a wide-eyed wonder that was so close to death. I learned to have the highest respect for fever, especially a high one. I learned that the bacteria that cause strep throat can be deadly. And I learned that no matter how healthy I am, I'm not invincible.

Here's what I would say to others: Do not ignore the symptoms.

If something seems wrong, it probably is. Trust your instincts; Only you know your body If you have a fever after giving birth, get immediate attention. And always err on the side of caution because the line between living and dying is thinner than I ever imagined.

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