Septic pelvic thrombophlebitis (SPT) was initially diagnosed and described in the late 1800's. The entity had a high incidence and mortality during this period of time, and a surgical therapeutic approach was the treatment of choice. Since then, the diagnosis, incidence, and management of the entity evolved. This evolution followed the development of newer diagnostic tools such as computed tomography (CT), magnetic resonance imaging (MRI), and a better understanding of the pathophysiology of the disease. The treatment of SPT has had significant changes as well, from a surgical approach at the end of the 19th century to a medical approach after the 1960's. By using an adequate broad-spectrum antibiotic therapy, mortality has decreased. However, controversy in the management of this entity remains even till today.

Objective: To test the hypothesis that our inner city obstetric patients who have been infected with sexually transmitted diseases (STDs) will have a higher prevalence of hepatitis C virus infection than the general population and to identify specific risk factors and high-risk groups.

Methods: All patients in our prenatal clinic (July 1997–April 1999) who tested positive for one or more STDs were asked to return for hepatitis C antibody testing. Medical charts of all patients who returned for hepatitis C testing were reviewed.

Results: A total of 106 patients with STDs were tested for hepatitis C. Positive screening tests for anti-hepatitis C antibody were found in 6.6% (7/106) of the patients (95% CI = 2.7–13.1%). This frequency is significantly higher than the hepatitis C prevalence (1.8%) in the general United States population (p = 0.006). Multiple logistic regression analysis confirmed only older age (p = 0.016) and positive HIV status (p = 0.023) to be significant predictors of hepatitis C infection.

Conclusions: Inner city STD-infected obstetric patients are at high risk for hepatitis C infection compared with the general population. Increasing age and HIV-positive status are risk factors which are significantly associated with hepatitis C infection.

The development of an acute parvovirus B-19 infection during pregnancy can cause pregnancy complications ranging from early pregnancy loss to nonimmune hydrops. There is no treatment, but preventive measures can be used to decrease perinatal mortality. The diagnosis is made on the basis of clinical suspicion and serology. If the fetus exhibits hydrops in the latter part of pregnancy, the main treatment options include either correcting the associated anemia with intrauterine blood transfusion or birth with extrauterine management. Although the serious problems associated with this virus during pregnancy are uncommon, they can be fatal. In view of this, a pregnant woman who is antibody negative should try to avoid contact with large groups of young children in order to decrease contact with potential vectors.

BACKGROUND: It is the purpose of this article to describe a suspected association of inadvertent vaccination with varicella vaccine during early pregnancy with the subsequent development of in utero miliary fetal tissue calcifications and fetal hydrops detected by sonogram at 15 weeks of gestation. CASE: This is a case presentation of a pregnant patient who received varicella vaccination during the same menstrual cycle that she became pregnant, and is supplemented by a literary review. The fetus developed miliary fetal tissue calcifications and fetal hydrops detected by a targeted sonogram at 15 weeks gestation. CONCLUSION: Varicella vaccination during early pregnancy may be a cause of miliary fetal tissue calcifications and fetal hydrops.

Background: Although cytomegalovirus (CMV) is an uncommon cause of viral hepatitis during pregnancy, a definitive diagnosis is important because of the potential for congenital CMV. In the case reported here, a diagnosis of hepatitis caused by CMV was made after the more common viral pathogens had been ruled out.

Case: A 17-year-old, 12-week pregnant patient was evaluated for fever and right upper quadrant tenderness. A serologic evaluation revealed elevated liver function levels and a positive maternal serology for CMV IgM. A diagnosis of hepatitis caused by CMV was made after the more common viral pathogens and drug-induced hepatitis had been ruled out. She was counseled about the potential effects of CMV on her fetus.

Conclusion: A step-wise approach to the diagnosis of viral hepatitis during pregnancy is needed to determine the etiology because a potential teratogenic virus may be involved.

Objective: To compare the epidemiology and hospital course of patients with acute salpingitis with and without coincident human immunodeficiency virus (HIV) seropositivity.

Methods: Patients admitted to the UMDNJ-University Hospital in Newark, New Jersey from January 1, 1991, to December 31, 1991, with acute salpingitis were studied.

Results: Eight percent of all hospitalized patients with acute salpingitis were HIV-positive. The mean age of the HIV-negative group was 25.4 compared with 29.6 years in the HIV-positive group. Gonorrhea and chlamydia were present in 49% and 22%, respectively, in HIV-negatives and in 40% and 20% of HIV-positives. Two of 5 (40%) HIV-positive patients had tuboovarian abscesses compared with 12 of 59 (20%) HIV-negative patients. Three of 5 (60%) HIV-positive patients had admission WBC counts fewer than 10,000/mm3 compared to 6 of 59 (12%) of HIV-negatives (P = 0.024). The hospital stay was 5.4 days for HIV-positives and 5.8 days for HIV-negatives.

Conclusions: Eight percent of hospitalized patients with acute salpingitis were HIV-seropositive. Neisseria gonorrhoeae and chlamydia were commonly found organisms in both groups. The initial WBC count was lower for HIV-positive patients. The hospital course of both groups was similar.