Spontaneous abortions and their relationship with listeria monocytogenes and cytomegalovirus: case report

Our aim is to make a case report about Listeriosis, the cytomegalovirus infection, and their relationship with spontaneous early abortions, considering its relevance during pregnancy.  First-pregnant patient, 19 years old, gestational age (GA) 20 weeks due to amenorrhea, attended to obstetr...

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Autores principales: Carracedo Ghione , C, Ortiz, F, Ortiz, E, Trezza, C, Bongiorni , C, Collaro, A, Lucchini, H, Di Cuatro, N
Formato: Artículo revista
Publicado: Universidad Nacional Córdoba. Facultad de Ciencias Médicas. Secretaria de Ciencia y Tecnología 2023
Materias:
listeria monocytogenes
cytomegalovirus
pregnancy
spontaneous abortions
gestación
aborto espontaneo
Acceso en línea:https://revistas.unc.edu.ar/index.php/med/article/view/42776
Aporte de:
Revista de la Facultad de Ciencias Médicas de Córdoba de Universidad Nacional de Córdoba
id I10-R327-article-42776
record_format ojs
institution Universidad Nacional de Córdoba
institution_str I-10
repository_str R-327
container_title_str Revista de la Facultad de Ciencias Médicas de Córdoba
format Artículo revista
topic listeria monocytogenes
cytomegalovirus
pregnancy
spontaneous abortions
listeria monocytogenes
cytomegalovirus
gestación
aborto espontaneo
spellingShingle listeria monocytogenes
cytomegalovirus
pregnancy
spontaneous abortions
listeria monocytogenes
cytomegalovirus
gestación
aborto espontaneo
Carracedo Ghione , C
Ortiz, F
Ortiz, E
Trezza, C
Bongiorni , C
Collaro, A
Lucchini, H
Di Cuatro, N
Spontaneous abortions and their relationship with listeria monocytogenes and cytomegalovirus: case report
topic_facet listeria monocytogenes
cytomegalovirus
pregnancy
spontaneous abortions
listeria monocytogenes
cytomegalovirus
gestación
aborto espontaneo
author Carracedo Ghione , C
Ortiz, F
Ortiz, E
Trezza, C
Bongiorni , C
Collaro, A
Lucchini, H
Di Cuatro, N
author_facet Carracedo Ghione , C
Ortiz, F
Ortiz, E
Trezza, C
Bongiorni , C
Collaro, A
Lucchini, H
Di Cuatro, N
author_sort Carracedo Ghione , C
title Spontaneous abortions and their relationship with listeria monocytogenes and cytomegalovirus: case report
title_short Spontaneous abortions and their relationship with listeria monocytogenes and cytomegalovirus: case report
title_full Spontaneous abortions and their relationship with listeria monocytogenes and cytomegalovirus: case report
title_fullStr Spontaneous abortions and their relationship with listeria monocytogenes and cytomegalovirus: case report
title_full_unstemmed Spontaneous abortions and their relationship with listeria monocytogenes and cytomegalovirus: case report
title_sort spontaneous abortions and their relationship with listeria monocytogenes and cytomegalovirus: case report
description Our aim is to make a case report about Listeriosis, the cytomegalovirus infection, and their relationship with spontaneous early abortions, considering its relevance during pregnancy.  First-pregnant patient, 19 years old, gestational age (GA) 20 weeks due to amenorrhea, attended to obstetric control, where no fetal heartbeat (FH) was observed. Presents an only tocogynecological ultrasound (TU): single fetus, positive FH. Unremarkable (UN) segmental examination. GA consistent with amenorrhea. TU was performed: negative FH. Fetal edema is observed, ultrasound GA 17.2 weeks, rest UN. Hospitalization is decided for control and treatment. Patient clinically and hemodynamically stable, afebrile. Admission laboratory within normal parameters. HIV, Hepatitis B, Syphilis, Chagas and Toxoplasmosis tests came negative. Vaginal delivery occurs, fetus is born without vital signs. Edema was observed in the thorax and abdomen with a purplish color, without other macroscopic malformations. Immediate puerperium UN. Serological studies cannot be expanded (Rubella, CMV and Parvovirus B 19). Deferred pathological anatomy reports: Macroscopy: female fetus. Globular abdomen with edema and low set of ears. Fetal placenta with congested vessels. Maternal face appears complete, with whitish areas. Microscopy: chorionic villi, characteristic of the 2nd trimester, lined by syncytotrophoblast, some edematous. Others with dystrophic calcification. Presence of Hofbaüer cells (placental macrophages), neutrophilic polomorphonuclear inflammatory infiltrate with necrosis (microabscess formation linked to Listeria) and eosinophilic inclusions with a perinuclear halo (suggestive of cytomegalovirus, positive with immunohistochemistry.) The anatomopathological findings allow us to reflect on infections with high maternal-fetal morbidity and mortality, despite their subclinical condition, thus reinforcing the symptoms to suspect them in time and the measures to take into account during pregnancy to prevent them. Listeriosis is a rare but eventually severe infection, more frequently in pregnancy due to the associated physiological immunosuppression, and also in direct relationship with early abortions during the first and second trimester, and with preterm births and neonatal infection during the third trimester. Regarding cytomegalovirus infection, no relationship was established with spontaneous abortions, other gestational complications being more frequent (intrauterine growth restriction and post-birth sequelae).
publisher Universidad Nacional Córdoba. Facultad de Ciencias Médicas. Secretaria de Ciencia y Tecnología
publishDate 2023
url https://revistas.unc.edu.ar/index.php/med/article/view/42776
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spelling I10-R327-article-427762023-10-19T21:19:19Z Spontaneous abortions and their relationship with listeria monocytogenes and cytomegalovirus: case report Abortos tempranos y su relación con la listeria monicytogenes y el citomegalovirus: reporte de un caso Carracedo Ghione , C Ortiz, F Ortiz, E Trezza, C Bongiorni , C Collaro, A Lucchini, H Di Cuatro, N listeria monocytogenes cytomegalovirus pregnancy spontaneous abortions listeria monocytogenes cytomegalovirus gestación aborto espontaneo Our aim is to make a case report about Listeriosis, the cytomegalovirus infection, and their relationship with spontaneous early abortions, considering its relevance during pregnancy.  First-pregnant patient, 19 years old, gestational age (GA) 20 weeks due to amenorrhea, attended to obstetric control, where no fetal heartbeat (FH) was observed. Presents an only tocogynecological ultrasound (TU): single fetus, positive FH. Unremarkable (UN) segmental examination. GA consistent with amenorrhea. TU was performed: negative FH. Fetal edema is observed, ultrasound GA 17.2 weeks, rest UN. Hospitalization is decided for control and treatment. Patient clinically and hemodynamically stable, afebrile. Admission laboratory within normal parameters. HIV, Hepatitis B, Syphilis, Chagas and Toxoplasmosis tests came negative. Vaginal delivery occurs, fetus is born without vital signs. Edema was observed in the thorax and abdomen with a purplish color, without other macroscopic malformations. Immediate puerperium UN. Serological studies cannot be expanded (Rubella, CMV and Parvovirus B 19). Deferred pathological anatomy reports: Macroscopy: female fetus. Globular abdomen with edema and low set of ears. Fetal placenta with congested vessels. Maternal face appears complete, with whitish areas. Microscopy: chorionic villi, characteristic of the 2nd trimester, lined by syncytotrophoblast, some edematous. Others with dystrophic calcification. Presence of Hofbaüer cells (placental macrophages), neutrophilic polomorphonuclear inflammatory infiltrate with necrosis (microabscess formation linked to Listeria) and eosinophilic inclusions with a perinuclear halo (suggestive of cytomegalovirus, positive with immunohistochemistry.) The anatomopathological findings allow us to reflect on infections with high maternal-fetal morbidity and mortality, despite their subclinical condition, thus reinforcing the symptoms to suspect them in time and the measures to take into account during pregnancy to prevent them. Listeriosis is a rare but eventually severe infection, more frequently in pregnancy due to the associated physiological immunosuppression, and also in direct relationship with early abortions during the first and second trimester, and with preterm births and neonatal infection during the third trimester. Regarding cytomegalovirus infection, no relationship was established with spontaneous abortions, other gestational complications being more frequent (intrauterine growth restriction and post-birth sequelae). Nuestro objetivo es realizar un reporte de caso respecto a la Listeriosis, la infección por citomegalovirus, y la relación de ambos con los abortos tempranos, considerando asi su relevancia durante el embarazo. Paciente primigesta, 19 años, edad gestacional (EG) 20 semanas por amenorrea, concurre a control obstétrico, donde no se constatan latidos cardiacos fetales (LCF). Presenta única ecografía tocoginecológica (TG): feto único, LCF positivos. Examen segmentario sin particularidades (SP). EG acorde con amenorrea. Se realiza ecografía TG: LCF  negativos. Se observa edema fetal,  EG ecografica 17.2 semanas, resto SP. Se decide internación para control y tratamiento. Paciente clínica y hemodinamicamente estable, afebril. Laboratorio de ingreso dentro de parámetros normales. HIV, Hepatitis B, Sifilis, Chagas y Toxoplasmosis negativas.  Se produce parto vaginal, nace feto sin signos vitales. Se objetiva edema en tórax y abdomen de coloración violácea, sin otras malformaciones macroscópicas. Puerperio inmediato SP. No se logran ampliar estudios serologicos (Rubeola, CMV y Parvovirus B 19). La anatomía patológica diferida informa: Macroscopía: feto femenino. Abdomen globuloso con edema e implantación baja de las orejas. Placenta cara fetal con vasos congestivos.  Cara materna impresiona completa, con áreas blanquecinas. Microscopia: vellosidades coriales,características del 2 trimestre revestidas por sincitotrofoblasto, algunas edematosas. Otras con calcificación distrófica. Presencia de Cel. de Hofbaüer (macrofagos placentarios), infiltrado inflamatorio polomorfonuclear neutrófilo con necrosis (formación de microabscesos vinculable con Listeria) e inclusiones eosinófilos con halo perinuclear (sugestivo de citomegalovirus, + con inmunohistoquimicas.)  Los hallazgos anatomopatologicos nos permiten reflexionar acerca de infecciones con alta morbimortalidad materno fetal, pese a su cuadro subclinico, reforzando asi la sintomatologia para sospecharlas a tiempo y las medidas a tener en cuenta durante la gestación para prevenirlas. La listeriosis es una infección rara pero eventualmente severa, con mayor frecuencia en la gestacion por la inmunodepresion fisiologica asociada. En relacion directa con abortos tempranos durante el primer y segundo trimestre, y con partos pretermino e infeccion neonatal durante el tercer trimestre.  En cuanto a la infeccion por citomegalovirus, no se establecio una relación del mismo con abortos espontáneos, siendo otras sus complicaciones gestacionales mas fecuentes (restriccion del crecimiento intrauterino y  secuelas post nacimiento). Universidad Nacional Córdoba. Facultad de Ciencias Médicas. Secretaria de Ciencia y Tecnología 2023-10-19 info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion https://revistas.unc.edu.ar/index.php/med/article/view/42776 Revista de la Facultad de Ciencias Médicas de Córdoba.; Vol. 80 (2023): Suplemento JIC XXIV Revista de la Facultad de Ciencias Médicas de Córdoba; Vol. 80 (2023): Suplemento JIC XXIV Revista da Faculdade de Ciências Médicas de Córdoba; v. 80 (2023): Suplemento JIC XXIV 1853-0605 0014-6722 Derechos de autor 2023 Universidad Nacional de Córdoba http://creativecommons.org/licenses/by-nc/4.0

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