Journal of Global Infectious Diseases

LETTER TO EDITOR
Year
: 2011  |  Volume : 3  |  Issue : 1  |  Page : 101--102

A case of Staphylococcus lugdunensis related pyomyoma occurring after cesarean section


Hamid Salim Shaaban, Hoo Feng Choo, John W Sensakovic 
 Department of Infectious Diseases, St Michael's Medical Center, Newark, NJ

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




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;3:101-102


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 2020 Jul 8 ];3:101-102
Available from: http://www.jgid.org/text.asp?2011/3/1/101/77311


Full Text

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}{Figure 2}

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

1Tobias DH, Koenigsberg M, Kogan M, Edelman M, LevGur M. Pyomyoma after uterine instrumentation. A case report. J Reprod Med 1996;41:375-8.
2Mason T, Adair J, Lee Y. Postpartum pyomyoma. J Natl Med Assoc 2005;97:826-8.
3Greenspoon 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.
4Bello 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.
5Sah SP, Rayamajhi AK, Bhadani PP. Pyomyoma in a postmenopausal woman: A case report. Southeast Asian J Trop Med Public Health 2005;36:979-81.