Postpartum fever in the presence of a fibroid: Sphingomonas paucimobilissepsis associated with pyomyoma

Borgo, Cosmo Del; Maneschi, Francesco; Belvisi, Valeria; Morelli, Francesca; Vetica, Angelo; Marocco, Raffaella; Tieghi, Tiziana; Lichtner, Miriam; Mastroianni, Claudio Maria

doi:10.1186/1471-2334-13-574

Cited by 21 publications

(19 citation statements)

References 21 publications

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“…Data from private hospitals that cater to the wealthy might show different patterns and, combined with our data from the public sector, might reveal a more robust U-shaped relationship between income and AMR in India. Finally, we identified 2 isolates of Sphingomonas spp., organisms commonly found in a variety of nonhost environments and occasionally identified as nosocomial pathogens ( 2 ) or as pathogens in pregnant women ( 33 ). One of the isolates was highly resistant to antimicrobial drugs, including all carbapenems in the study.…”

Section: Discussionmentioning

confidence: 99%

Poverty and Community-Acquired Antimicrobial Resistance with Extended-Spectrum β-Lactamase–Producing Organisms, Hyderabad, India

Alsan¹,

Nagamani²,

Jyothi³

et al. 2018

Emerg. Infect. Dis.

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The decreasing effectiveness of antimicrobial agents is a global public health threat, yet risk factors for community-acquired antimicrobial resistance (CA-AMR) in low-income settings have not been clearly elucidated. Our aim was to identify risk factors for CA-AMR with extended-spectrum β-lactamase (ESBL)–producing organisms among urban-dwelling women in India. We collected microbiological and survey data in an observational study of primigravidae women in a public hospital in Hyderabad, India. We analyzed the data using multivariate logistic and linear regression and found that 7% of 1,836 women had bacteriuria; 48% of isolates were ESBL-producing organisms. Women in the bottom 50th percentile of income distribution were more likely to have bacteriuria (adjusted odds ratio 1.44, 95% CI 0.99–2.10) and significantly more likely to have bacteriuria with ESBL-producing organisms (adjusted odds ratio 2.04, 95% CI 1.17–3.54). Nonparametric analyses demonstrated a negative relationship between the prevalence of ESBL and income.

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Section: Discussionmentioning

confidence: 99%

Poverty and Community-Acquired Antimicrobial Resistance with Extended-Spectrum β-Lactamase–Producing Organisms, Hyderabad, India

Alsan¹,

Nagamani²,

Jyothi³

et al. 2018

Emerg. Infect. Dis.

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“…Complications of fibroids in the postpartum period are rare, but have been described. Pyomyoma is a life‐threatening complication resulting from infarction and infection of fibroids . It can present with abdominal pain, fever and septicaemia with common organisms such as Clostridium .…”

Section: Postnatal Carementioning

confidence: 99%

Fibroids in pregnancy: management and outcomes

Sampat

Alleemudder

2018

The Obstetric & Gynaecologis

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Key content In pregnancy, fibroids can lead to complications such as placental abruption and increased caesarean section rates. Surgical intervention of fibroids within the first two trimesters is possible in selected women. Increasing evidence suggests that myomectomy can be performed concurrently with caesarean section without an increased risk of blood transfusion or hysterectomy. Adverse outcomes are associated with subsequent pregnancies following uterine artery embolisation. Learning objectives To outline the complications of fibroids and treatment options in pregnancy. To determine pregnancy outcomes in those previously treated for uterine fibroids, including with uterine artery embolisation and ulipristal acetate. To discuss the mode of delivery in women with a previous myomectomy. Ethical issues With the provision of informed consent, should women with a previous myomectomy be encouraged to proceed with vaginal delivery? A greater rate of certain complications has been observed in pregnancies that follow uterine artery embolisation. Should this information be provided routinely?

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“…The transmission route postpartum is usually ascending infection, which will lead to the colonization of necrotic tissue. However, it can also spread from the uterine cavity or any adjacent structures or by distant hematogenous/lymphatic spread [4,[11][12][13][14].…”

Section: Discussionmentioning

confidence: 99%

Prolapsed submucosal pyomyoma postpartum, a rare complication of fibroids

Wang

Sun

2021

BMC Pregnancy Childbirth

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Background Pyomyoma is an unusual fibroid that usually develops during the puerperal or postmenopausal period. If not promptly diagnosed and treated, it can become life threatening. Although various conservative and surgical therapies have been discussed in the literature for this condition, there are very few reports related to the management of prolapsed pedunculated submucosal myoma. Case presentation In this case report, an intramural fibroid transformed into a pedunculated submucosal pyomyoma, which prolapsed into the vagina after a miscarriage and caused life-threatening toxic shock. Apart from prompt antibiotic treatment, a transabdominal myomectomy rather than hysterectomy was performed due to the very large diameter of the pyomyoma. As a result, fertility was preserved, and the patient conceived naturally and delivered a healthy baby two years later. Discussion and conclusions It is important to maintain strong clinical suspicion for pregnant or postpartum women with a triad of pain, sepsis without an obvious source and a known diagnosis of leiomyoma. Timely recognition and prompt surgical treatment with antibiotics are necessary and could conserve the uterus for future fertility.

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Postpartum fever in the presence of a fibroid: Sphingomonas paucimobilissepsis associated with pyomyoma

Cited by 21 publications

References 21 publications

Poverty and Community-Acquired Antimicrobial Resistance with Extended-Spectrum β-Lactamase–Producing Organisms, Hyderabad, India

Poverty and Community-Acquired Antimicrobial Resistance with Extended-Spectrum β-Lactamase–Producing Organisms, Hyderabad, India

Fibroids in pregnancy: management and outcomes

Prolapsed submucosal pyomyoma postpartum, a rare complication of fibroids

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