• Biwei Wen, Xiaomin Yu, Yue Yin, Runan Zhao, and Yuhuan Liu.
• Department of Obstetrics and Gynecology, The First Affiliated Hospital of Naval Medical University, Shanghai, China.
• Medicine (Baltimore). 2024 Jan 26; 103 (4): e37009e37009.

RationaleUterine abscess is a rare gynecologic entity and only a few cases have been reported so far. This study aimed to describe our clinical experience in this case. Initially, hematoma was diagnosed without detail previous medical record. Finally, laparotomy was performed due to refractory fever and highly possible diagnosis of uterine abscess. We successfully performed a hysterectomy and the patient had an uneventful recovery.Patient ConcernsA 44-year-old nulliparous woman underwent myomectomy in the local hospital, 45 days ago. She complained of irregular fever (up to 40 °C) without abdominal pain since the surgery.DiagnosesDue to lack of her detail medical record, equivocal images and her strong intention to preserve uterus, she was misdiagnosed with hematoma and treated with antibiotic treatment. Finally, intraoperative findings revealed that the huge myometrial abscess contained a mass of pus.InterventionsLaparotomy was performed due to refractory high-grade fever and highly possible diagnosis of uterine abscess. Total hysterectomy was performed to avoid the possibility of life-threatening sepsis.OutcomesThe postoperative course was uneventful and the patient was discharged 10 days after surgery.LessonsComplete imaging examinations are recommended prior myomectomy to facilitate the differential diagnosis of postoperative complications. In addition, several measures, such as maintaining aseptic conditions during surgery and postoperative drainage, play a critical role in preventing nosocomial infections. Rare uterine abscess is often mistaken for hematoma with fever. If the patient develops high fever after myomectomy, accompanied by a mass in the myometrium, the possibility of infection or even abscess formation should not be excluded. For women who need to preserve their fertility, the early diagnosis and timely administration of appropriate medication is crucial for preventing uterine loss.Copyright © 2024 the Author(s). Published by Wolters Kluwer Health, Inc.

37 keywords...

hide…