Case Reports in Women's Health (Oct 2022)

Postpartum pyomyoma due to Mycoplasma hominis: A case report

  • Tomohiro Mitoma,
  • Hikaru Oba,
  • Sakurako Mishima,
  • Akiko Ohira,
  • Satoe Kirino,
  • Kazumasa Tani,
  • Jota Maki,
  • Eriko Eto,
  • Kei Hayata,
  • Hisashi Masuyama

Journal volume & issue
Vol. 36
p. e00456

Abstract

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Pyomyoma is a rare condition that causes fever and abdominal pain associated with pregnancy, especially in the postpartum period. An appropriate diagnosis and early medical intervention are required to prevent serious complications. A 38-year-old primigravida with uterine fibroids had fever from the 11th day after cesarean section. The fever did not resolve despite repeated daily administration of broad-spectrum β-lactam antibiotics for 2 weeks. Although the physical examination did not show any lower abdominal pain, a pelvic magnetic resonance scan revealed degenerative fibroids, and myomectomy was performed. Yellow-greenish odorless pus inside the uterus was detected, and Mycoplasma hominis was detected in the pus culture. Mycoplasma species are resistant to broad-spectrum penicillin antibiotics and can cause pyomyoma. Pyomyomas may not cause uterine tenderness, and the causative organism may be difficult to identify; therefore, additional imaging studies should be considered.

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