Sepsis following hysteroscopic removal of retained products of conception: A case report and literature review.

RATIONALE

Sepsis following hysteroscopy is an rare complication, with current evidence suggesting that routine prophylactic antibiotic administration may not be warranted. However, this does not imply that we should disregard vigilance regarding the potential occurrence of severe infections post-hysteroscopy.

PATIENT CONCERNS

A 27-year-old female underwent hysteroscopic resection of retained products of conception after incomplete medical abortion. After 10 hours postoperatively, the patient developed hyperthermia (39.9°C), tachycardia (137 beats/min), and hypotension (77/36 mm Hg). The blood test results revealed elevations in procalcitonin to 15.02 ng/mL, leukocytosis count to 18.1 × 109/L, neutrophils to 97.1%, and C-reactive protein level of 51.50 mg/L.

DIAGNOSES

Sepsis was diagnosed according to the Quick Sepsis-related Organ Failure Assessment. Histopathological examination of retained products of conception demonstrated abundant inflammatory infiltrates, with immunohistochemical analysis revealing CD138-positive plasma cell clusters.

INTERVENTIONS

Empirical broad-spectrum antibiotics and fluid resuscitation were administered.

OUTCOMES

The patient made a satisfactory recovery and was discharged 7 days postoperatively.

LESSONS

A retrospective analysis of post-hysteroscopic sepsis and septic shock cases was performed. Although postoperative infections exhibited a low incidence, our findings emphasize the necessity for increased clinical vigilance and prompt initiation of pathogen-directed therapies when severe infections arise.