Clinical Manifestations and Pathology

Among puerperae the clinical manifestations of puerperal sepsis include acute fever, profuse lochial flow, and an enlarged and tender uterus. Onset is generally between 2 and 5 days after delivery. Normally there is inflammation of the endometrium and surrounding structures as well as of the lymphatic and vascular systems. One also finds pelvic cellulitis, septic pelvic thrombophlebitis, peritonitis, and pelvic abscesses. Among neonates, infection usually becomes apparent in the first 5 days after birth, but onset is sometimes delayed by several weeks. Symptoms include lethargy, poor feeding, and abnormal temperature. Infection by group B streptococci is often clinically indistinguishable from other bacterial infections.

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