A case of puerperal sepsis due to ESBL E. coli with multi-organ involvement: A clinical challenge

Abstract

We report a complex case of puerperal sepsis in a 22-year-old primigravida woman, caused by an ESBL (Extended Spectrum Beta-Lactamase) producing Escherichia coli, leading to multi-organ dysfunction. The patient developed acute liver injury, thrombocytopenia, and peripartum cardiomyopathy following a vacuum-assisted vaginal delivery at a peripheral hospital. She presented clinical signs of systemic infection including fever, jaundice, dizziness, foul-smelling vaginal discharge, and hypertension. Laboratory and microbiological investigations confirmed the presence of a resistant strain of E. coli from vaginal swab and pus samples. Intensive multidisciplinary management, including supportive care and targeted antibiotic therapy, resulted in full recovery. This case highlights the critical importance of early detection and appropriate treatment in managing postpartum sepsis caused by drug-resistant organisms.