From the Department of Obstetrics and Gynecology, Thomas Jefferson University, Philadelphia, Pennsylvania; and the Department of Obstetrics and Gynecology, Albert Einstein Medical Center, Philadelphia, Pennsylvania.
Obstet Gynecol. 2011 Feb;117(2 Pt 2):466-467. doi: 10.1097/AOG.0b013e3181f73805.
Postpartum endometritis is usually a polymicrobial infection caused by organisms that are part of the normal vaginal flora. A pathologically confirmed case of postpartum endometritis secondary to herpes and cytomegalovirus in a human immunodeficiency virus (HIV)-positive patient is reported.
A 29-year-old, HIV-positive woman presented 6 days postpartum with abdominal pain and foul-smelling vaginal discharge. Pelvic ultrasonography revealed retained products of conception. Dilation and evacuation was performed, and antibiotics were started. Despite adequate antibiotics and laparoscopic drainage of a pelvic collection, fevers and pain continued. A total abdominal hysterectomy, salpingectomy, and appendectomy were performed. Pathology reported herpes and cytomegalovirus infection of the uterus.
Herpes simplex virus (HSV) and cytomegalovirus need to be considered as a potential cause of postpartum endometritis. When antibiotic therapy fails, an antiviral regimen should be considered.
产后子宫内膜炎通常是由正常阴道菌群中的微生物引起的混合感染。报告了一例人免疫缺陷病毒（HIV）阳性患者因单纯疱疹病毒和巨细胞病毒引起的产后子宫内膜炎的病例。
一名 29 岁 HIV 阳性妇女产后 6 天出现腹痛和恶露有臭味。盆腔超声显示有妊娠物残留。行扩宫和刮宫术，并开始使用抗生素。尽管使用了足够的抗生素和腹腔镜引流盆腔脓肿，发热和疼痛仍持续存在。行全子宫切除术、输卵管切除术和阑尾切除术。病理报告显示子宫单纯疱疹病毒（HSV）和巨细胞病毒感染。
单纯疱疹病毒和巨细胞病毒需要被视为产后子宫内膜炎的潜在病因。当抗生素治疗失败时，应考虑抗病毒治疗方案。
