Case Reports in Medicine
Volume 2013, Article ID 973297, 5 pages
http://dx.doi.org/10.1155/2013/973297
First Trimester Typhoid Fever with Vertical Transmission of Salmonella Typhi, an Intracellular Organism
1Department of Obstetrics and Gynecology, Warren Alpert Medical School of Brown University, East Providence, RI 02914-5300, USA
2Department of Pediatrics, Microbial Pathogenesis and Host Defense Program, University of California, San Francisco, CA 94143-0654, USA
Received 20 October 2013; Accepted 19 November 2013
Academic Editor: Florian Thalhammer
Copyright © 2013 Marguerite B. Vigliani and Anna I. Bakardjiev. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
We report a case in which placental abruption occurred at 16 weeks following first trimester diagnosis and treatment for typhoid fever. Unexpectedly Salmonella enterica serovar Typhi (S. Typhi) was found in fetal tissues at autopsy. Using information from the murine model of typhoid fever in pregnancy, we draw parallels between S. Typhi and L. monocytogenes to develop a plausible hypothesis to explain how this organism was able to cross the placenta in the first trimester to cause abruption, inflammation, and expulsion of the fetus and placenta. We hope that this model for understanding placental infections by the hematogenous route helps to raise awareness that organisms not typically associated with TORCH infection can nevertheless cause placental infection and pregnancy loss.