An Unusual Cause of Postabortal Fever Requiring Prompt Surgical Intervention: A Pyomyoma and its Imaging Features

• Main Authors: Rashmi Bagga, Rakhi Rai, Jasvinder Kalra, Pradip K Saha, Tulika Singh
• Format: Article
• Language: English
• Published: Oman Medical Specialty Board 2017-01-01
• Series: Oman Medical Journal
• Subjects: Leiomyoma; Fever; Postabortion; Postpartum; CT Scan
• Online Access: http://omjournal.org/articleDetails.aspx?coType=1&aId=1865

Pyomyoma is an unusual complication of leiomyoma, occurring most commonly in the postpartum, postabortal, and post-menopausal periods. It develops due to infection in necrotic foci within leiomyoma, which is more common during pregnancy due to rapid growth, and in postmenopausal women due to vascular insufficiency. Other contributing factors are curettage, gynecological surgery, cervical stenosis, immunodeficiency, and recently, uterine artery embolization. It presents with a typical triad of sepsis, leiomyoma, and absence of any apparent source of infection. We report a case of persistent postabortal fever in a 26-year-old female due to a pyomyoma, which resolved after a myomectomy. Pyomyoma may become life threatening in the event of intraperitoneal rupture resulting in pyoperitoneum and septic shock. Hence, gynecologists should consider this diagnosis in women with a leiomyoma and sepsis in the absence of any apparent source of infection.