Mukai Shinichi, Isono Hiroki, Kondo Keisuke, Ihara Kousuke, Isono Momoko, Ogawa Haruki
General Medicine, HITO Medical Center, Ehime, JPN.
Obstetrics and Gynaecology, HITO Medical Center, Ehime, JPN.
Cureus. 2022 Nov 29;14(11):e32016. doi: 10.7759/cureus.32016. eCollection 2022 Nov.
Pyometra is an easily overlooked disease with nonspecific symptoms; however, a delayed diagnosis can lead to severe complications. An 80-year-old frail woman presented to our hospital with a chief complaint of persistent fever for 10 days. Her blood tests showed an elevated inflammatory response, and computed tomography showed a 10-cm cystic lesion in the pelvic floor compressing the bladder. A catheter was inserted from the vagina into the uterine cavity, resulting in pus drainage and pyometra diagnosis. A pus culture was subsequently performed, which detected , a common cause of respiratory tract infections in cystic fibrosis and bloodstream infections, and. To the best of our knowledge, this is the first report of pyometra caused by . The patient was treated with drainage and piperacillin-tazobactam administration. Pyometra is especially prevalent in older women with impaired activities of daily living and dementia. Although fever, lower abdominal pain, and increased discharge may occur, symptoms are often nonspecific, and half of such cases are asymptomatic. Furthermore, delayed diagnosis can lead to perforation of the uterus and consequent pan-peritonitis. Thus, the diagnosis of pyometra should be considered in older women presenting with unknown fever, and imaging studies and gynecological consultation should be requested promptly.
子宫积脓是一种症状不具特异性、容易被忽视的疾病；然而，延迟诊断可能会导致严重并发症。一名80岁体弱女性因持续发热10天为主诉前来我院就诊。她的血液检查显示炎症反应升高，计算机断层扫描显示盆底有一个10厘米的囊性病变压迫膀胱。从阴道插入导管至子宫腔，引出脓液，确诊为子宫积脓。随后进行了脓液培养，检测到 ，这是囊性纤维化患者呼吸道感染和血流感染的常见病因，以及 。据我们所知，这是首例由 引起的子宫积脓报告。患者接受了引流及哌拉西林-他唑巴坦治疗。子宫积脓在日常生活活动能力受损和患有痴呆症的老年女性中尤为普遍。虽然可能会出现发热、下腹部疼痛和分泌物增多，但症状往往不具特异性，且此类病例中有一半是无症状的。此外，延迟诊断可能会导致子宫穿孔及随之而来的全腹膜炎。因此，对于出现不明原因发热的老年女性应考虑子宫积脓的诊断，并应及时进行影像学检查及咨询妇科医生。
