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Pyomyoma after uterine instrumentation. A case report
D H Tobias1, M Koenigsberg, M Kogan
1Department of Obstetrics and Gynecology, Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, New York 10461, USA.
The Journal of Reproductive Medicine
|May 1, 1996
Summary
Pyomyoma, a rare uterine infection, is often linked to uterine instrumentation. This case highlights its occurrence after an elective abortion, emphasizing the need for vigilance in diagnosing such infections.
Area of Science:
- Gynecology
- Infectious Diseases
- Medical Case Reports
Background:
- Pyomyoma is an exceptionally rare uterine infection, with only 10 reported cases since 1945.
- While four cases were associated with pregnancy, none were linked to elective abortion or uterine instrumentation.
Observation:
- A 32-year-old woman presented with symptoms of infection, including abdominal pain and fever, 10 weeks post-elective second-trimester abortion.
- Pelvic sonography revealed an enlarged uterus with a complex mass; uterine curettage yielded minimal tissue and no definitive diagnosis.
- Exploratory laparotomy identified peritonitis and multiple pyomyomas discharging purulent material.
Findings:
- The patient's presentation and subsequent surgical findings confirmed a diagnosis of pyomyoma.
- This case represents a rare instance of pyomyoma following elective abortion and uterine instrumentation.
Implications:
- Pyomyoma should be considered in the differential diagnosis for patients with uterine myomas and signs of infection, especially after uterine instrumentation.
- Early recognition and appropriate management are crucial for favorable outcomes in these rare cases.