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Case Report: Recurrent Pyometra in an Adolescent.

Kathryn Schmiech1, Courtney Woods1, Jordan Hylton1

  • 1Department of Obstetrics and Gynecology, Virginia Commonwealth University, Richmond, Virginia.

Journal of Pediatric and Adolescent Gynecology
|June 24, 2020
PubMed
Summary

Pyometra, a uterine infection, rarely affects adolescents but can occur with medical conditions. This case highlights the need for considering pyometra in young patients with specific risk factors, even when symptoms are atypical.

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Area of Science:

  • Gynecology
  • Adolescent Medicine
  • Reproductive Health

Background:

  • Pyometra is a rare uterine infection typically seen in postmenopausal women.
  • It is exceptionally uncommon in premenopausal individuals, especially adolescents.

Observation:

  • A 16-year-old female with significant comorbidities presented with symptoms suggestive of infection after depot medroxyprogesterone acetate treatment.
  • Initial ultrasound indicated hematometra, but hysteroscopy confirmed pyometra, necessitating surgical evacuation.
  • Recurrent episodes required multiple evacuations and ultimately a total laparoscopic hysterectomy for definitive management.

Findings:

  • Pyometra can occur in adolescents, particularly those with comorbidities and factors leading to endometrial atrophy.
  • Management can be complex, involving repeated interventions and potentially hysterectomy in severe or recurrent cases.
Keywords:
HysterectomyMenstrual suppressionPyometraUrogential hygiene

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Implications:

  • This case underscores the importance of considering pyometra in the differential diagnosis of adolescent females presenting with lower abdominal pain, fever, and vaginal discharge.
  • Clinicians should be aware of risk factors such as prolonged use of hormonal contraceptives causing endometrial atrophy and poor genitourinary hygiene.
  • Prompt diagnosis and management are crucial to prevent complications and guide treatment strategies, including surgical intervention when necessary.