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Case Reports in Obstetrics and Gynecology
Volume 2011, Article ID 364641, 3 pages
http://dx.doi.org/10.1155/2011/364641
Case Report

Severe Clostridial Pyomyoma following an Abortion Does Not Always Require Surgical Intervention

1Department of Obstetrics and Gynecology, Hadassah-Hebrew University Medical Center, Jerusalem 91240, Israel
2Department of Radiology, Hadassah-Hebrew University Medical Center, Jerusalem 91240, Israel

Received 17 June 2011; Accepted 13 July 2011

Academic Editor: S. Rasmussen

Copyright © 2011 Daphna Stroumsa et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background. Clostridial infection following pregnancy may be fatal, and surgery is considered as the treatment of choice. We suggest a conservative management in selected cases when preservation of fertility is of major importance. Case. A 41-year-old primigravida presented with abdominal pain and fever, one day following dilatation and curettage at 20 weeks of gestation. Her abdomen was diffusely tender, with a uterus enlarged to 20 weeks' gestation. Laboratory studies were consistent with sepsis and hemolysis. CT demonstrated a gas-containing mass compressing the uterine cavity, and presence of air in pelvic veins. Blood cultures were positive for Clostridium perfringens. The patient was treated conservatively, with IV antibiotics and fluid resuscitation, and recovered. Conclusion. In selected cases of infected myoma complicated by clostridial sepsis, refraining from surgical intervention is a possible therapeutic approach.