Uterine pyomyoma as a complication of pregnancy in an intravenous drug user.

Pyomyoma (suppurative leiomyoma) is a rare entity characterized by infarction and infection of a uterine leiomyoma. Pyomyomas may pose both diagnostic and therapeutic difficulties, leading to potential complications such as bacteremia, uterine rupture, and even death. In the case we describe, uterine pyomyoma occurred as a complication of pregnancy in a 31-year-old woman with a history of intravenous drug abuse. We postulate that the patient's illicit drug use caused transient bacteremia resulting in bacterial seeding of a uterine leiomyoma that had infarcted due to pregnancy. Therapy consisted of total abdominal hysterectomy and intravenous antibiotic administration. We believe this is the first reported case of a pyomyoma developing in association with intravenous drug abuse.