Asian Research Journal of Gynaecology and Obstetrics

Aims: Clostridium Septicum sepsis in pregnancy is exceedingly rare and highly fatal, with only two previously reported maternal survivors. We present a third case, highlighting the importance of early recognition, aggressive management, and multidisciplinary care which ultimately led to a full recovery.

Presentation of Case: A 30-year-old Gravida 4 Para 3 Indonesian woman presented with abdominal pain, heavy bleeding, and prolonged leaking liquor. Initial assessment suggested septic miscarriage with possible abruptio placenta. On admission, she developed pyrexia, metabolic acidosis, and coagulopathy. Emergency hysterotomy was performed due to worsening hemodynamic status. Despite surgical intervention, the patient developed toxic shock syndrome with multiorgan failure. Blood cultures confirmed Clostridium septicum. She received intensive care support, blood product transfusions, and escalation of antimicrobials. Multidisciplinary management by infectious disease, surgical, nephrology, orthopedic, maxillofacial, neurosurgery, and rehabilitation teams guided her to full recovery.

Discussion: C. Septicum’s virulence arises from toxin production and aerotolerance, often causing rapid systemic deterioration. Early recognition, prompt surgical source control, intensive care, and multidisciplinary collaboration are essential for survival. The patient survived without requiring a hysterectomy. The patient’s young age and absence of comorbidities likely contributed to her survival.

Conclusion: Survival from C. Septicum sepsis in pregnancy is possible with timely recognition, immediate empirical antibiotics, prompt surgical intervention, intensive monitoring, and coordinated multidisciplinary care. This case contributes to the limited literature and underscores strategies for managing this rare, life-threatening infection.