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Published online by Cambridge University Press:  05 August 2015

Department of Obstetrics and Gynecology, Warren Alpert Medical School of Brown University, Providence, RI
Department of Pediatrics, Microbial Pathogenesis and Host Defense Program, University of California, San Francisco, CA
Dr Marguerite B. Vigliani, MD, Clinical Professor Obstetrics and Gynecology, Warren Alpert Medical School of Brown University, 450 Veterans Memorial Parkway, Suite 101, East Providence, RI 02914, USA. Email:


In an era of evidence-based medicine, physicians sometimes forget the value of anecdotes in stimulating thought about clinical problems. Our recent report on typhoid fever in a pregnant woman at 12 weeks of gestation is a good example. In spite of culture-proven diagnosis and appropriate treatment of the mother with antibiotics, fetal loss occurred at 16 weeks of gestation. Salmonella typhi was found in the fetal lung on autopsy, consistent with vertical transmission of the organism. None of the clinicians caring for the patient had imagined that gram-negative bacteria could cross the placenta and kill the fetus in spite of early diagnosis and treatment with appropriate antibiotics.

Copyright © Cambridge University Press 2015 

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