1/3. Cystic degeneration of a leiomyoma masquerading as a postoperative abscess.Leiomyomas are common tumors that usually have a typical sonographic appearance. With degeneration, however, the sonographic findings may be completely uncharacteristic. We report a case of a multicystic anterior uterine wall mass detected at antenatal sonography in an asymptomatic patient. Differential diagnosis included myoma, varicosity, hematoma, abscess, uterine anomaly, and pelvic neoplasm. At cesarean section, the mass was confirmed to be a myoma. Postoperatively, an ultrasound was performed by the radiology service during evaluation of suspected endometritis and the mass was interpreted as an endometrial abscess. This case illustrates that myomas can present with sonographic features consistent with a number of pathologic disorders. This variable pattern of echogenicity may sometimes create difficulty in establishing a correct diagnosis. The case also demonstrates the importance of communication between services and the need for not only antenatal but also postpartum and gynecologic ultrasound studies to be performed by physicians trained in sonographic findings of the abnormal uterus.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
2/3. Fatal toxic shock syndrome associated with clostridium sordellii after medical abortion.endometritis and toxic shock syndrome associated with clostridium sordellii have previously been reported after childbirth and, in one case, after medical abortion. We describe four deaths due to endometritis and toxic shock syndrome associated with C. sordellii that occurred within one week after medically induced abortions. Clinical findings included tachycardia, hypotension, edema, hemoconcentration, profound leukocytosis, and absence of fever. These cases indicate the need for physician awareness of this syndrome and for further study of its association with medical abortion.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
3/3. Subacute staphylococcal meningitis secondary to postpartum endometritis.A woman with staphylococcus aureus meningitis following postpartum endometritis presented with lumbar backache and fever of several weeks' duration. Thick, green exudate was aspirated at lumbar puncture hours before death. Histologic examination demonstrated subacute inflammation of the meninges and chronic inflammation of the endometrium. Although rare, postpartum endometritis followed by low back pain and fever should alter the physician to the possibility of serious infection involving the central nervous system. diagnosis and treatment at this early stage would be expected to decrease mortality.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |