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In July 2005, the FDA issued an alert regarding four reports of fatal sepsis in women following medical abortion. At that time, Clostridium sordellii had been identified as the infection-causing organism in two of the women. Now, researchers have confirmed that C. sordellii caused toxic shock syndrome in all four women.
The otherwise healthy women (age range, 18–34) underwent medical abortion at 43 to 53 days’ gestation with 200 mg of oral mifepristone followed by 800 μg of vaginal misoprostol. They presented 4 to 5 days later with nonspecific complaints including abdominal pain, vomiting, and diarrhea. Presentations were marked by tachycardia, hypotension, and marked leukocytosis; absence of fever, myonecrosis, and gas production; and rapid…