Aetiology

Possible causes of puerperal pyrexia include :

• genital tract infection - on examination the woman may have a bulky tender uterus. There may be perineal infection without involvement of the upper genital tract
• urinary tract infection
• deep vein thrombosis
• mastitis
• respiratory tract infection - this is more common after anaesthesia.
• non-puerperal related causes eg appendicitis
• anaemia

The commonest organisms are, in order of prevalence:

• Streptococci - both anaerobic and occasionally the beta-haemolytic streptococcus, e.g. S.agalactiae
• staphylococci
• coliforms
• anaerobes eg bacteroides
• chlamydia
• mycoplasma
• Clostridium welchii - very rare, but can cause a serious genital tract infection