[page 32] [Infectious Disease Reports 2015; 7:5801]

Intra-amniotic Leptotrichia buccalis has not been previously associated with adverse preg-nancy outcome. We report a case of chorioam-nionitis and pregnancy loss associated with this primarily oral commensal. We review Leptotrichia buccalis and other oral commen-sals that have been identified in cases of intra-amniotic infection. Case Report A 35-year-old multigravida woman with a history of loop electrosurgery excision proce-dure (LEEP) six months prior to index preg-nancy, presented at 19 weeks and 1 day for an anatomy ultrasound. At that time, her cervical length was noted to be 9 mm. She was coun-seled on management options including vagi-nal progesterone, cerclage, a purse-string stitch placed in the cervix, and expectant man-agement. She elected for expectant manage-ment. One week later on a follow-up ultra-sound, she had no measurable cervical length and prolapsing membranes through the exter-nal os. A sterile speculum examination con-firmed the location of the membranes, with no evidence of rupture. She was afebrile and without fundal tender-ness. She had a white blood cell count of 9.9×109/L. Options, including expectant man-agement and cerclage, were discussed with the patient and she desired cerclage placement attempt. Amniocentesis was performed to assess the presence of a sub-clinical infection prior to a cerclage placement. The Gram stain was negative for organisms, the white blood cell count was 9.5 cells/mm3, and the glucose was <20 mg/dL, which is the lowest reportable value to which our hospital instruments are validated. Urinalysis showed no sign of infec-tion. A nucleic acid amplification testing for Chlamydia trachomatis and Neisseria gonor-rhoeae (Gen-Probe APTIMA Combo 2 Assay