PUERPERAL SEPTICEMIA 299 



general system. Puerperal septicemia accompanies to a 

 greater or less extent most forms of septic infection of the 

 reproductive organs during the puerperal state. 



Etiology.— Puerperal septicemia results invariably from 

 retention of placenta, a fetus or fetuses, or from wounds 

 acquired during or following parturition. Putrefaction 

 changes in the retained placenta occur rapidly, other infection 

 is introduced, and the products of bacteria or the bacteria 

 themselves are taken into the circulation producing a general 

 septicemia or sapremia. This disease may follow normal 

 birth, dystocia, etc. 



Pathology.— The changes in the reproductive organs are 

 often slight as compared to the severity of the symptoms. 

 The blood is thin, does not coagulate readily. The muscles 

 are pale, soft and friable. Ecchymoses are observed on the 

 serous membranes, particularly in the abdominal cavity. 

 Parenchymatous degeneration is noted in the liver, kidneys 

 and spleen. 



Symptoms.— The symptoms develop rapidly, usually in 

 from one to three days following parturition. There is 

 great depression, the animal lying down most of the time; 

 elevated temperature (106°-107° F.), increased respirations 

 and pulse. Later appear great prostration, subnormal tem- 

 perature, cold extremities, etc. 



Locally the generative organs show marked changes in 

 some cases, such as swelling of the vulva, the mucosa of the 

 vagina; in others little change will be found. There is nearly 

 always a copious discharge from the vulva, consisting of a 

 greenish colored pus, containing shreds of placenta and 

 other material. This discharge has a very offensive odor. 



The bowels are irregular, in some cases constipation will 

 be present and in others a severe diarrhea. The symptoms 

 usually increase in intensity, the animal reaching a stage 

 of coma or collapse. In the milder forms of infection, and 

 particularly in sapremic conditions, the symptoms gradually 

 disappear and the animals make a complete recovery. 



Diagnosis.— This is made on the sudden onset, the severe 

 general symptoms, the high temperature in the early stages, 

 and the characteristic involvement of the reproductive organs. 



