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Related Concept Videos

Disorders of the Female Reproductive System01:24

Disorders of the Female Reproductive System

236
The female reproductive system can be affected by several disorders, including Premenstrual Syndrome (PMS), Premenstrual Dysphoric Disorder (PMDD), endometriosis, and various forms of cancer. PMS and PMDD are cyclical conditions that cause physical and emotional distress, with symptoms that include edema, mood swings, and food cravings. PMDD is a more severe form of PMS characterized by increased symptom severity that peaks during the luteal phase and tends to improve or resolve shortly after...
236
Disorders of the Urinary System01:20

Disorders of the Urinary System

179
The urinary system is responsible for eliminating waste and excess fluids from the body. However, disorders of the urinary system can arise due to various reasons like infections, stress, age, congenital abnormalities, and lifestyle.
Urinary tract infections (UTIs) are one of the most common urinary system disorders. They are caused by bacteria that enter the urethra and can spread to the bladder resulting in cystitis. Pyelonephritis is the result of a UTI that has ascended to the level of the...
179

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Ruptured uterine pyomyoma with multiorgan dysfunction syndrome.

Faryal Anees1, Dur-E-Shahwar2, Rozilla Sadia Khan1

  • 1Obstetric and Gynecology, The Aga Khan University Hospital, Karachi, Sindh, Pakistan.

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Summary

A woman with a necrotic fibroid developed Escherichia coli sepsis, leading to septic shock and organ failure. Prompt surgical intervention and intensive care resulted in a successful recovery and resolution of infection.

Keywords:
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Area of Science:

  • Gynecology
  • Infectious Diseases
  • Critical Care Medicine

Background:

  • A woman with chronic hypertension and recent myomectomy presented with severe symptoms suggestive of infection.
  • She exhibited signs of septic shock, acute kidney injury, and respiratory failure.
  • Imaging revealed a necrotic fibroid, hydrosalpinx, ascites, and pleural effusion.

Purpose of the Study:

  • To report a case of severe Escherichia coli infection secondary to a degenerating uterine fibroid.
  • To highlight the diagnostic and management challenges in a patient with multiple comorbidities.
  • To emphasize the importance of timely surgical and medical intervention in managing complex gynecological emergencies.

Main Methods:

  • Clinical presentation and initial management in the emergency department.
  • Diagnostic workup including imaging and blood cultures.
  • Surgical intervention: total abdominal hysterectomy, bilateral salpingoophorectomy, and hysteroscopy.
  • Postoperative intensive care and follow-up.

Main Results:

  • Blood cultures and intraoperative findings confirmed Escherichia coli infection.
  • Pathology revealed leiomyomata with degenerative changes, endometrial polyps, and endometriosis.
  • The patient required intensive care for septic shock, acute kidney injury, and respiratory failure.
  • Successful recovery with resolution of symptoms and no recurrence after treatment.

Conclusions:

  • Degenerating uterine fibroids can lead to severe sepsis and multi-organ failure.
  • Multidisciplinary management involving critical care and surgical teams is crucial.
  • Early diagnosis and aggressive treatment, including surgical debridement and antibiotics, are vital for favorable outcomes.