Pyrexia of unknown origin associated with a non-infected vaginal shelf pessary

An 82-year-old female was admitted with pyrexia and rigors. Bloods showed a raised C-reactive protein and she was commenced on empirical intravenous antibiotics. Chest X-ray, urine microscopy and computed tomography scan of the patient's abdomen and pelvis did not demonstrate a source of infection, and blood cultures did not grow a microorganism. A collateral history was taken from the patient's husband who raised concerns regarding her vaginal shelf pessary and it was therefore removed. Subsequently the patient's fever subsided, her inflammatory markers improved and she was discharged 2 days later. We believe this is the first reported case of pyrexia secondary to a non-infected vaginal pessary, and may provide clinicians with an additional line of enquiry when presented with patients with pyrexia of unknown origin.