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Pyometra due to Pseudomonas aeruginosa
Nathan McLeod1, Allison Lastinger1
1Department of Medicine, Section of Infectious Diseases, PO Box 9163, West Virginia University School of Medicine, Morgantown, WV, 26506-9214, United States.
Abstract:
Pyometra is an unusual presentation of uterine infection, this condition is characterized by purulent fluid within the uterine cavity. In this report we describe pyometra due to Pseudomonas aeruginosa in a 90-year-old woman who presented with abdominal pain, nausea with emesis and diarrhea. She was evaluated at an outside emergency department and computed tomography (CT) revealed a large, complex, cystic mass measuring 9.2 cm (cm) in greatest diameter. Given her age, the diagnosis of malignancy was entertained. She was referred to gynecologic-oncology service for evaluation and underwent exploratory laparotomy with total abdominal hysterectomy and lysis of adhesions. Intraoperative findings were consistent with pyometra. Cultures ultimately grew Pseudomonas aeruginosa. She initiated on antibacterial therapy and was discharged to a rehabilitation facility.
Insights
Pyometra, a uterine infection with pus, is rarely caused by Pseudomonas aeruginosa. This case highlights a rare instance in a 90-year-old woman, emphasizing prompt diagnosis and treatment for this serious condition.
Area of Science:
- Gynecology
- Infectious Diseases
- Oncology
Background:
- Pyometra is a rare uterine condition characterized by purulent fluid accumulation.
- It can mimic gynecologic malignancies, especially in elderly patients.
Observation:
- A 90-year-old woman presented with abdominal pain, nausea, vomiting, and diarrhea.
- Computed tomography revealed a large, complex cystic mass, raising concerns for malignancy.
Findings:
- Exploratory laparotomy confirmed pyometra.
- Cultures identified Pseudomonas aeruginosa as the causative agent.
Implications:
- This case underscores the importance of considering pyometra in the differential diagnosis of complex adnexal masses in elderly women.
- Prompt identification and appropriate antibiotic therapy are crucial for successful management and patient recovery.
