Ruptured uterine pyomyoma with multiorgan dysfunction syndrome

Article Text Abstract A woman with a history of chronic hypertension, no previous pregnancies and a recent myomectomy presented to the emergency department with fever, vomiting, diarrhoea and abdominal pain. She showed signs of septic shock, acute kidney injury and respiratory failure. Imaging revealed a large necrotic fibroid, hydrosalpinx, ascites and pleural effusion. Blood cultures showed Escherichia coli growth. She underwent emergency surgery for total abdominal hysterectomy, bilateral salpingoophorectomy and hysteroscopy. Intraoperatively, purulent discharge was found, and cultures confirmed E. coli infection. Pathology revealed leiomyomata with degenerative changes, benign endometrial polyps and endometriosis. Postoperatively, she received intensive care and showed gradual improvement, eventually being discharged in a stable condition. Follow-up appointments showed resolution of symptoms, wound healing and no infection recurrence. Antibiotics were discontinued, and the pleural drain was removed. Overall, the patient had a successful recovery with no complications noted during follow-up. - Infections - Obstetrics, gynaecology and fertility Statistics from Altmetric.com Footnotes Contributors FA: Conceptualisation, investigation, writing – original draft, writing – review and editing and visualisation. DS: Conceptualisation, literature review, review and editing, and supervision. She is the guarantor. RSK: Conceptualisation, review and supervision. TK: Literature review and visualisation. Each author has approved the final version of the manuscript and agrees to be accountable for all aspects of the work. Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors. Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy. Competing interests None declared. Provenance and peer review Not commissioned; externally peer reviewed.