Case Reports in Obstetrics and Gynecology

Case Report

Postpartum Pyomyoma, a Rare Complication of Sepsis Associated with Chorioamnionitis and Massive Postpartum Haemorrhage Treated with an Intrauterine Balloon

Table 1

Details of reports of pyomyoma in association with pregnancy.


Author	Age (years)	Gestation	Background	Presentation	Organism	Treatment	Complications	Outcome

Present case	28	23 + 1 weeks	Known leiomyoma Preterm labour GBS positive	Abdominal pain PV bleeding Fever	Escherichia coli	Antibiotics Laparotomy and myomectomy	Septicaemia	Well

Sirha et al. [9]	37	10 days postpartum	27-week preterm delivery Caesarean section	Fever Vomiting	Unknown	Antibiotics Total abdominal hysterectomy	Sepsis	Well

Del Borgo et al. [10]	37	30 days postpartum	SVD at 39 weeks	Fever	Sphingomonas paucimobilis	Antibiotics Abdominal myomectomy	Septicaemia	Well

Kobayashi et al. [11]	28	20 weeks	Degenerating leiomyoma at 18-week gestation	Abdominal pain Fever Vaginal discharge	Anaerobic Gram-negative rods	Exploratory laparotomy Myomectomy at 21 weeks of gestation	Peritonitis	Well Caesarean section at 37 weeks

Shaaban et al. [12]	30	8 weeks postpartum	Caesarean section Known leiomyoma	Fever Abdominal pain	Staphylococcus lugdunensis	Antibiotics Exploratory laparotomy Myomectomy	Peritonitis	Well

Laubach et al. [8]	31	29 weeks	Preterm prelabour rupture of membranes Footling breech Caesarean section Previous myomectomy	Fever	Enterococcus faecalis Streptococcus species	Antibiotics CT guided drainage Subtotal abdominal hysterectomy	Wound infection	Well

Laubach et al. [8]	35	33 weeks	Preterm labour Footling breech Chorioamnionitis Caesarean section Previous myomectomy	Fever Abdominal pain	Escherichia coli Candida albicans Candida dubliniensis	Antibiotics CT guided drainage	N/A	Well

Laubach et al. [8]	31	18 hours after ERPC for miscarriage	13-week pregnancy	Fever Abdominal pain	Escherichia coli	Antibiotics CT guided drainage	N/A	Well

Nguyen and Gruenewald [13]	40	3 weeks postpartum	Caesarean section at 41 weeks Chorioamnionitis	Fever Abdominal pain	Escherichia coli	Antibiotics Total abdominal hysterectomy	Sepsis	Well

Mason et al. [4]	29	21 days postpartum	SVD at term MROP	Fever Abdominal pain Vomiting	No growth	Antibiotics Exploratory laparotomy Myomectomy	Sepsis Endometritis

Karcaaltincaba and Sudakoff [7]	36	7 days after spontaneous 2nd trimester miscarriage	17-week gestation Known leiomyoma	Abdominal pain Fever	Peptostreptococcus tetradrus	Exploratory laparotomy Myomectomy	Peritonitis	Well

Lin et al. [14]	33	6 days postpartum	33 weeks Preterm labour Caesarean section Known leiomyoma	Abdominal pain Fever	Candida parapsilosis	Antibiotics Total abdominal hysterectomy	Septic shock Endometritis Wound infection	Well

Grüne et al. [15]	44	26 weeks	Known leiomyoma Caesarean section	Fever	Klebsiella pneumoniae	Antibiotics Myomectomy	Sepsis	Well

Prahlow et al. [16]	31	12 weeks	Ongoing pregnancy Intravenous drug abuse Previous PID	Abdominal pain Constipation	Staphylococcus aureus	Total abdominal hysterectomy & BSO Antibiotics	Peritonitis	Well

Tobias et al. [17]	32	10 weeks after surgical TOP at 15 weeks	Known leiomyoma	Abdominal pain Fever	Enterococcus faecalis	Antibiotics Total abdominal hysterectomy & BSO	Peritonitis	Well

Prichard et al. [18]	37	9 weeks after 2nd trimester miscarriage	Known leiomyoma Exploratory Laparotomy 18 weeks earlier for abdominal mass	Fever Weight loss	Streptococcus milleri	Antibiotics Total abdominal hysterectomy & BSO	Infective endocarditis	Well

Wong et al. [19]	29	18 weeks	Intrauterine device in situ Chorioamnionitis leading to miscarriage	Fever	Staphylococcus aureus Serratia marcescens	Antibiotics Total abdominal hysterectomy & LSO	Hemoperitoneum	Well

Ruch [20]	32	24 weeks	Preterm labour Known leiomyoma	Fever Abdominal pain Lethargy	Gram-positive cocci	Antibiotics Total abdominal hysterectomy & BSO	Peritonitis	Well

Dubois and Neumann [21]	29	3 weeks postpartum	SVD at term	Fever Abdominal pain	Unknown	Antibiotics Vaginal expulsion/myomectomy	N/A	Well

Case described in this paper.
BSO: bilateral salpingo-oophorectomy; NVD: normal vaginal delivery; TOP: termination of pregnancy; MROP: manual removal of placenta; ERPC: evacuation of retained products of conception; PID: pelvic inflammatory disease.