Severe postpartum sepsis secondary to a deep vaginal hematoma: clinical and therapeutic aspects

Abstract

Introduction. Puerperal sepsis is still a life-threatening obstetric complication worldwide, even in settings with advanced medical resources. Clinical manifestations may be subtle and atypical during pregnancy and the puerperium, leading to delays in recognition and treatment. Multidrug-resistant organisms such as Stenotrophomonas maltophilia further complicate management, often requiring aggressive multidisciplinary approaches.

Case presentation. We present a case of vaginal hematoma and peripartum infection with Stenotrophomonas maltophilia accompanied by multiple organ dysfunction syndrome.

Conclusions. The presence of pelvic contusion leads to sepsis caused by multiple infections in the peripartum period and can significantly increase the incidence of diseases associated with bleeding, infection, surgery, and blood product transfusions. The clinical condition of the patient may be worsened in the presence of pre-existing conditions prior to pregnancy.