A State of Septic Shock Revealing a Pyomyoma as An Exceptional Complication Post Abortum

Abstract

Pyomyoma is a pyogenous infection of a leiomyoma and occurs when a leiomyoma under goes infarction and subsequent infection. It is a rare, yet potentially fatal complication of uterine leiomyoma. We report the case of a 42-year-old tunisian woman,20 weeks of gestation, who presented with rupture of membrane. In her ultrasonography, in 20 weeks of gestation, she had 18 cm × 16 cm sub-mucosal to intramural myoma and a normal fetus. a cesarean section was performed for suspected chorioamniotitis with a failed induction. Seven days later, she presented with fever and lower abdominalpain.

In physical examination, she had blood pressure:100/70mmHg, pulse rate: 110 beats per minute and temperature:39.5°C. She had tenderness on uterus and uterine height was 24 weeks. Ultrasonography showed a hetero-echoic mass (18 cm × 16 cm × 12 cm) in posterior side of uterus and endometrial thickness was 8 mm. With diagnosis of endometritis or infected myoma, she was admitted and received intravenous.