Perinatal infection: a case report

Background. Often, to avoid ascending infection and chorioamnionitis (that could be a threat for both mother and child) during pregnancy, it is mandatory to use antibiotics. Sometimes the choice of the right therapy is more challenging than expected.
Case presentation. This case report is about a patient hospitalized on the 05/29/24 in the AOU Federico II of Naples. Her diagnosis was “Threat of abortion”, because the cervix was not measurable, the amniotic sac was protruding into vagina and the foetus was at a so early (22 weeks) gestational age that it could not survive outside of the uterus in case of birth.
Thanks to antibiotics (ampicillin, clarithromycin, piperacillin + tazobactam, meropenem, cefazolin, vancomycin, imipenem + cilastatin + relebactam) used a lot of times during hospitalization, it has been possible to avoid chorioamnionitis and delay the delivery till the foetus could reach a gestational age mature enough to survive in extra-uterine environment. The vacuum assisted vaginal delivery happened on 09/05/2024 during the 37^th week of gestation.
Conclusions. Despite the positive cervical and vaginal swabs, the positive urine culture and the spread of bacteria in blood vessels of the patient, the infection has been tamed and the mother has returned finally home on 09/10/2024 with her baby. This example shows how tailored medicine is capable to obtain huge gains on the foetal and maternal wellness and hopefully this kind of medical approach will be used more often in future.