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LETTER TO EDITOR  
Year : 2011  |  Volume : 3  |  Issue : 1  |  Page : 101-102
A case of Staphylococcus lugdunensis related pyomyoma occurring after cesarean section


Department of Infectious Diseases, St Michael's Medical Center, Newark, NJ,

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Date of Web Publication4-Mar-2011
 

How to cite this article:
Shaaban HS, Choo HF, Sensakovic JW. A case of Staphylococcus lugdunensis related pyomyoma occurring after cesarean section. J Global Infect Dis 2011;3:101-2

How to cite this URL:
Shaaban HS, Choo HF, Sensakovic JW. A case of Staphylococcus lugdunensis related pyomyoma occurring after cesarean section. J Global Infect Dis [serial online] 2011 [cited 2016 Jul 24];3:101-2. Available from: http://www.jgid.org/text.asp?2011/3/1/101/77311


Sir,

Pyomyoma (suppurative leiomyoma) is a rare condition occurring from infarction and infection of a leiomyoma that typically occurs in pregnant women or postmenopausal women who have vascular disease. [1] It can result in complications, such as bacteremia, uterine rupture, and even death. [2] The diagnostic triad of pyomyoma is the following: 1) sepsis; 2) leiomyoma uteri; and 3) no other apparent source of infection. [3]

A 30-year-old female presented with fever and a 6 Χ 5 cm painful abdominal mass with purulent discharge [Figure 1]. She had fibroids and eight weeks prior to admission, she had an uncomplicated cesarean section. CT revealed pedunculated fibroids, largest measuring 8.6 Χ 5.9 cm [Figure 2] with secondary degenerative infection. Wound cultures grew Staphylococcus lugdunensis, Staphylococcus epidermidis and Peptostreptococus. She was started on intravenous vancomycin and avelox. At exploratory laparotomy, she was found to have a uterus with pus-filled necrotic fibroids protruding through the abdominal wall. She had a resection of the necrotic fibroids and repair of the abdominal wall. Cultures grew Staphylococcus lugdunensis. She was discharged home one week later.
Figure 1: Abdominal mass protruding through umbilicus with purulent discharge

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Figure 2: CT scan of abdomen confirming gas in the leiomyoma

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S. lugdunensis-related pyomyomas have never been described in the literature and may tend to have a more fulminant course unlike infections caused by other coagulase-negative staphylococci. [4]

A delay in diagnosis may result in fatal complications, [5] which was not the case in our patient who received adequate surgery and broad-spectrum antibiotics that decreased serious morbidity and mortality.

 
   References Top

1.Tobias DH, Koenigsberg M, Kogan M, Edelman M, LevGur M. Pyomyoma after uterine instrumentation. A case report. J Reprod Med 1996;41:375-8.  Back to cited text no. 1
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2.Mason T, Adair J, Lee Y. Postpartum pyomyoma. J Natl Med Assoc 2005;97:826-8.  Back to cited text no. 2
    
3.Greenspoon JS, Ault M, James BA, Kaplan L. Pyomyoma associated with polymicrobial bacteremia and fatal septic shock: Case report and review of the literature. Obstet Gynecol Surv 1990;45:563-9.  Back to cited text no. 3
[PUBMED]    
4.Bello C, Eskandar M, El GR, Sobande A, Nour H, Shafiq H. Staphylococcus lugdunensis endometritis: A case report. West Afr J Med 2007;26:243-5.  Back to cited text no. 4
[PUBMED]    
5.Sah SP, Rayamajhi AK, Bhadani PP. Pyomyoma in a postmenopausal woman: A case report. Southeast Asian J Trop Med Public Health 2005;36:979-81.  Back to cited text no. 5
[PUBMED]    

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Correspondence Address:
Hamid Salim Shaaban
Department of Infectious Diseases, St Michael's Medical Center, Newark, NJ

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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0974-777X.77311

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    Figures

  [Figure 1], [Figure 2]

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