Chikamatsu Hayato, Taki Mana, Kitamura Sachiko, Sunada Masumi, Yamanoi Koji, Murakami Ryusuke, Yamaguchi Ken, Horie Akihito, Tsuchido Yasuhiro, Hamanishi Junzo, Mandai Masaki
Department of Gynecology and Obstetrics, Kyoto University Graduate School of Medicine, Kyoto, Japan.
Department of Clinical Laboratory Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan.
Case Rep Infect Dis. 2024 Oct 21;2024:4114954. doi: 10.1155/2024/4114954. eCollection 2024.
is one of the most common endemic mycoplasmas in the genitourinary tract and can cause amniotic fluid infection leading to preterm labor. We report a rare case of infection ascending from the vagina to the abdominal cavity after hysterectomy, causing vaginal cuff infection, postoperative peritonitis, and small bowel obstruction. A 29-year-old nulliparous woman presented with infected uterine cervical cancer. After radical hysterectomy for uterine cervical cancer, the patient had paralytic ileus with ascites and fever. Peritonitis was suspected; however, all cultures were negative, making it difficult to identify the causative organism. Polymerase chain reaction (PCR) of the ascites revealed , which could be treated with levofloxacin (LVFX). Open drainage to control the infection revealed a necrotic tissue around vaginal cuff and the small intestine encased in cocoon-like fibers like sclerosing encapsulating peritonitis. After the infection was improved, the bowel obstruction was also improved. spp. can be difficult to culture. PCR testing for infection should be considered when urogenital infection is suspected in patients prone to opportunistic infections, such as those with malignant tumors.
是泌尿生殖道中最常见的地方性支原体之一，可引起羊水感染导致早产。我们报告了一例罕见病例，子宫切除术后感染从阴道蔓延至腹腔，导致阴道残端感染、术后腹膜炎和小肠梗阻。一名29岁未生育的女性患有感染性子宫颈癌。子宫颈癌根治性子宫切除术后，患者出现麻痹性肠梗阻、腹水和发热。怀疑有腹膜炎；然而，所有培养结果均为阴性，难以确定病原体。腹水的聚合酶链反应（PCR）检测显示 ，可用左氧氟沙星（LVFX）治疗。开放引流以控制感染，发现阴道残端周围有坏死组织，小肠被茧样纤维包裹，类似硬化性包裹性腹膜炎。感染改善后，肠梗阻也有所改善。 属细菌可能难以培养。对于易发生机会性感染的患者，如患有恶性肿瘤的患者，当怀疑有泌尿生殖道感染时，应考虑进行 感染的PCR检测。
