Clinics in diagnostic imaging (199). Pyometra.

Area of Science:

• Geriatric Medicine
• Radiology
• Gynecology

Background:

• Pyometra is a rare condition involving uterine cavity distension with pus.
• Prompt diagnosis is crucial, especially in elderly patients presenting with non-specific symptoms.

Observation:

• A 92-year-old female presented with urinary symptoms, fever, and suprapubic tenderness.
• Elevated inflammatory markers were noted, but urine and blood cultures were negative.
• Computed tomography (CT) demonstrated a distended uterine cavity with high-attenuation fluid, an air-fluid level, and gas locules.

Findings:

• CT imaging is vital for diagnosing pyometra, revealing characteristic features within the uterine cavity.
• The imaging findings in this case strongly suggested pyometra, despite negative cultures.
• The presentation highlights the importance of considering pyometra in elderly women with sepsis symptoms.

Implications:

• This case underscores the utility of CT in identifying pyometra, even with atypical presentations.
• Understanding the imaging features of pyometra aids in timely diagnosis and management.
• Further research into the causes and optimal treatment strategies for pyometra in the geriatric population is warranted.