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取卵后行体外受精导致子宫积脓并最终行子宫切除术。

Pyometra after ovum retrieval for in vitro fertilization resulting in hysterectomy.

机构信息

Department of Obstetrics and Gynecology, Maimonides Medical Center, Brooklyn, New York 11219, USA.

出版信息

Fertil Steril. 2010 Jan;93(1):268.e1-2. doi: 10.1016/j.fertnstert.2009.08.023. Epub 2009 Nov 25.

Abstract

OBJECTIVE

To report infection and pyometra after ovum retrieval for IVF.

DESIGN

Case report.

SETTING

Community hospital.

PATIENT(S): A 43-year-old woman with a recent history of ovum retrieval presented with high fever, chills, and no gynecologic symptoms. The patient was admitted to the medical intensive care unit due to septicemia. After an extensive workup for fever, the patient was diagnosed with pyometra, and biopsy of the endometrial cavity revealed vancomycin-resistant enterococci.

INTERVENTION(S): The patient was treated with antibiotics and then discharged home. Two weeks later she presented with unrelenting fever and abdominal pain and underwent hysterectomy.

MAIN OUTCOME MEASURE(S): Unrelenting infection despite antibiotic treatment resulting in hysterectomy, which showed autolyzed endometrium, subserosal and intramural abscess.

RESULT(S): Infection resolved after hysterectomy.

CONCLUSION(S): Pyometra should be considered in the differential diagnosis of fever after ovum retrieval as it may result in serious consequences and can be life threatening.

摘要

目的

报告一例体外受精取卵后发生感染和子宫积脓的病例。

方法

病例报告。

地点

社区医院。

患者

一位 43 岁女性,近期有取卵病史,表现为高热、寒战,无妇科症状。因败血症,该患者被收入内科重症监护病房。在对发热进行了广泛的检查后,患者被诊断为子宫积脓,子宫内膜腔活检显示万古霉素耐药肠球菌。

干预措施

患者接受抗生素治疗后出院。两周后,她出现持续发热和腹痛,并接受了子宫切除术。

主要观察指标

尽管进行了抗生素治疗,但感染仍持续存在,导致子宫切除术,术中可见自溶子宫内膜、浆膜下和壁内脓肿。

结果

子宫切除术后感染得到缓解。

结论

取卵后发热时应考虑子宫积脓的鉴别诊断,因为它可能导致严重后果,甚至危及生命。

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