Peritonitis caused by Mycoplasma hominis after laparoscopic total hysterectomy: A case report

Abstract

Infections after obstetric and gynecologic surgery are commonly caused by enterobacteria, commensal vaginal bacteria, or indigenous skin bacteria (primarily Staphylococcus aureus and Streptococcus). Mycoplasma hominis (M. hominis) rarely causes postoperative infection in the field of obstetrics and gynecology and its treatment is generally delayed. This report describes a case report of peritonitis caused by M. hominis after laparoscopic total hysterectomy. A 44-year-old patient (gravida 1, para 1) presented with heavy menstrual bleeding and severe anemia. She was diagnosed as having multiple uterine fibroids and bilateral endometriomas and underwent laparoscopic surgery. She subsequently developed postoperative peritonitis due to M. hominis. This microorganism was identified in the postoperative cultures of the vaginal discharge and the transvaginal drainage fluid by matrix-assisted laser desorption/ionization time-of-flight mass spectrometry. The patient was treated successfully with the appropriate antimicrobial agents. It is important to consider M. hominis infection when gynecological postoperative infection persists despite treatment with beta-lactam antibiotics, and no causative organisms are identified by Gram staining.

Keywords

• Endometrioma
• Peritonitis
• Mycoplasma hominis
• Laparoscopic hysterectomy