{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,30]],"date-time":"2025-12-30T22:52:40Z","timestamp":1767135160751,"version":"build-2238731810"},"reference-count":6,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2021,10,7]],"date-time":"2021-10-07T00:00:00Z","timestamp":1633564800000},"content-version":"vor","delay-in-days":98,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["associationofanaesthetists-publications.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Anaesthesia Reports"],"published-print":{"date-parts":[[2021,7]]},"abstract":"Summary<\/jats:title>\n \n This report describes a challenging obstetric case in which septic emboli from\n Streptococcus oralis<\/jats:italic>\n endocarditis subsequently led to central nervous system infection. There were delays in diagnosis as the patient presented with non\u2010specific symptoms of fever, diarrhoea and vomiting, initially suspected to be due to viral gastroenteritis and later SARS\u2010CoV\u20102 infection. Antibiotics were commenced once gram positive cocci were isolated from a blood culture. The patient made no significant improvement despite antimicrobial therapy and subsequently developed a worsening headache and delirium. This deterioration was not rapidly recognised despite the use of a routine obstetric early warning score. However, a diagnosis of meningitis was made once the potential severity of the patient\u2019s condition was recognised and\n Streptococcus oralis<\/jats:italic>\n was identified in cerebrospinal fluid and blood cultures. Bacterial endocarditis was diagnosed following transthoracic echocardiography. The patient improved with optimised antimicrobial therapy and delivered a healthy baby. This example highlights how non\u2010specific symptoms can be caused by rare and life\u2010threatening illnesses, and emphasises that early warning scores might not easily identify neurological deterioration in obstetric patients.\n <\/jats:p>","DOI":"10.1002\/anr3.12133","type":"journal-article","created":{"date-parts":[[2021,10,8]],"date-time":"2021-10-08T21:20:38Z","timestamp":1633728038000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Streptococcus oralis<\/i>\n endocarditis leading to central nervous system infection in pregnancy"],"prefix":"10.1002","volume":"9","author":[{"given":"S.","family":"Wydall","sequence":"first","affiliation":[{"name":"Department of Anaesthesia Guy\u2019s and St. Thomas\u2019 NHS Foundation Trust London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"F.","family":"Durrant","sequence":"additional","affiliation":[{"name":"Department of Anaesthesia Guy\u2019s and St. Thomas\u2019 NHS Foundation Trust London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J.","family":"Scott","sequence":"additional","affiliation":[{"name":"Department of Anaesthesia Guy\u2019s and St. Thomas\u2019 NHS Foundation Trust London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"K.","family":"Cheesman","sequence":"additional","affiliation":[{"name":"Department of Anaesthesia Guy\u2019s and St. Thomas\u2019 NHS Foundation Trust London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2021,10,7]]},"reference":[{"key":"e_1_2_5_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.SMJ.0000054503.18393.1E"},{"key":"e_1_2_5_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.mayocp.2014.04.024"},{"key":"e_1_2_5_4_1","unstructured":"National Institute for Health and Care Excellence.Meningitis \u2010 Bacterial Meningitis and Meningococcal Disease 2020.www.cks.nice.org.uk\/topics\/meningitis\u2010bacterial\u2010meningitis\u2010meningococcal\u2010disease(accessed 23\/04\/2021)."},{"key":"e_1_2_5_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1469-0691.2011.03465.x"},{"key":"e_1_2_5_6_1","first-page":"862","article-title":"A modified early obstetric warning system","volume":"22","author":"Cole M","year":"2014","journal-title":"Journal of Midwifery"},{"key":"e_1_2_5_7_1","unstructured":"European Society of Cardiology.IE Summary Card 2016.www.escardio.org\/static\u2010file\/Escardio\/Guidelines\/Publications\/Summary%20card\/IE_2016\u2010_Summary_Card.pdf(accessed 23\/04\/2021)."}],"container-title":["Anaesthesia Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/anr3.12133","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/anr3.12133","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/associationofanaesthetists-publications.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/anr3.12133","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,8]],"date-time":"2025-10-08T17:27:17Z","timestamp":1759944437000},"score":1,"resource":{"primary":{"URL":"https:\/\/associationofanaesthetists-publications.onlinelibrary.wiley.com\/doi\/10.1002\/anr3.12133"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,7]]},"references-count":6,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2021,7]]}},"alternative-id":["10.1002\/anr3.12133"],"URL":"https:\/\/doi.org\/10.1002\/anr3.12133","archive":["Portico"],"relation":{},"ISSN":["2637-3726","2637-3726"],"issn-type":[{"value":"2637-3726","type":"print"},{"value":"2637-3726","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,7]]},"assertion":[{"value":"2021-09-15","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-10-07","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e12133"}}