Fever of unknown origin in the puerperium. A case report

Postpartum fever is a common problem for obstetricians, but fever of unknown origin (FUO) occurring in the puerperium may be relatively unfamiliar and a challenge to the majority of obstetricians.

A 29-year-old woman had a FUO detected during the puerperium. Despite serial examinations and therapeutic trials, the fever persisted for three weeks without a clinical improvement or definite infection source. The presence of a huge uterine myoma was observed. The patient finally underwent myomectomy, and a pathology review revealed a cellular leiomyoma associated with massive infarction and acute inflammation. The fever subsided substantially on the third day postoperatively.

Although a uterine leiomyoma as a cause of fever in the puerperium is not new, rarely does it cause prolonged fever. It should be taken into consideration in pregnant women known to have uterine myomas during pregnancy and in the puerperium, especially if FUO develops. Nonsteroidal antiinflammatory drugs can be a tool for making the differential diagnosis in such a patient, and exploratory laparotomy can be delayed until an emergency condition occurred, especially important during pregnancy.