Clinical presentation
The most common presenting signs and symptoms of infection among puerperal GAS infection were postpartum fever (48 patients, 84.2%), abdominal pain and/or tenderness (22, 38.5%), and/or tachycardia (15, 26.8%). Less common symptoms were back pain, headache, weakness, and dyspnoea. Cultures positive for GAS infection were obtained from various body sites and sterile liquids, mostly from the female genital tract (uterus, cervix, vagina, lochia, and placenta, 66%), followed by blood (36%), urine (13%), caesarean delivery and episiotomy wounds (6%). There were 28 puerperal women (49.1%) with GAS-positive cultures originating from more than one sites.