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Pyometra Perforation Caused by Actinomyces without Intrauterine Device Involvement
1Emergency Unit and Critical Care Center, Tsuyama Central Hospital, 1756 Kawasaki, Tsuyama, Okayama 708-0841, Japan.
Abstract:
An 86-year-old woman with diabetes mellitus and severe decubitus at the sacral and calcaneal regions stemming from poor daily activity was diagnosed with pyometra perforation caused by Actinomyces. No foreign materials, including an IUD, were found inside the uterus. Pyometra is usually caused by Enterobacteriaceae or anaerobes derived from the gastrointestinal tract. The virulence of Actinomyces is rather low, and, in almost all the reported cases of Actinomyces-related pyometra, an intrauterine device (IUD) was involved. Although rare, Actinomyces may be ascribed as a virulent pathogen that causes pyometra in the absence of foreign materials.
Insights
This study reports a rare case of uterine pyometra perforation caused by Actinomyces in an elderly woman without an intrauterine device (IUD). It highlights Actinomyces as a potential pathogen in pyometra, even without foreign materials.
Area of Science:
- Gynecology
- Infectious Diseases
- Pathogen Research
Background:
- Pyometra is typically associated with Enterobacteriaceae or gastrointestinal anaerobes.
- Actinomyces pyometra cases almost invariably involve an intrauterine device (IUD).
- The virulence of Actinomyces is generally considered low.
Purpose of the Study:
- To report a rare case of pyometra perforation caused by Actinomyces.
- To investigate Actinomyces as a causative agent in pyometra without foreign materials.
Main Methods:
- Case study of an 86-year-old woman with diabetes and decubitus ulcers.
- Diagnosis of pyometra perforation.
- Identification of Actinomyces as the causative pathogen.
- Exclusion of intrauterine devices (IUDs) and other foreign materials.
Main Results:
- Actinomyces was identified as the cause of pyometra perforation.
- No foreign materials, including an IUD, were found in the uterus.
- The patient presented with severe decubitus ulcers, indicating poor daily activity.
Conclusions:
- Actinomyces can cause uterine pyometra and perforation, even in the absence of an intrauterine device (IUD).
- This case underscores the potential virulence of Actinomyces in specific clinical contexts.
- Further research may be needed to understand Actinomyces-induced pyometra without foreign materials.
