Septic shock following hysteroscopy – A case report

Meneses, Tânia; Faria, Joana; Martins, Ana Teresa; Delgado, Elsa; Silva, Maria do Carmo

doi:10.1016/j.crwh.2020.e00182

Cited by 2 publications

(2 citation statements)

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“…One reported case of TOA and subsequent sepsis with E. coli bacteremia following an in-office hysteroscopy was within a patient with bilateral endometriomas, which have been implicated as an independent risk factor for the development of TOAs due to the presence of stagnant blood [9,10]. Other cases include an abscess following an operative hysteroscopy in which uterine perforation occurred, and TOA following a hysteroscopy on a patient who later was determined to likely have previously undiagnosed endometriosis [3,11].…”

Section: Discussionmentioning

confidence: 99%

“…Operative hysteroscopies are considered quite safe, with reported complication rates ranging from 1.2-3.8% for procedural failures, to less than 0.01% for infections [1]. The risk of post-hysteroscopy infection further decreases in patients with no known risk factors, such as nulliparity, active bacterial vaginosis, previous pelvic surgery, multiple sexual partners, or history of pelvic inflammatory disease [3,4]. Hysteroscopy with concomitant polypectomy has been associated with an even lower risk of complications at 0.4% as compared to concomitant endometrial resection, myomectomy, and adhesiolysis [5].…”

Section: Introductionmentioning

confidence: 99%

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Post-hysteroscopy Ruptured Tubo-Ovarian Abscess With Atypical Bacteremia: A Case Report

Linck,

Torres,

Dayal

2023

Cureus

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Hysteroscopies are commonly performed in the diagnosis and treatment of patients with abnormal uterine bleeding. Current research suggests a low rate of all types of complications following hysteroscopies. The rate of infectious complications has been reported as exceptionally low. We present a case of tubo-ovarian abscess with Escherichia coli bacteremia and eventual abscess rupture in a 51-year-old gravida 3, para 2012 (G3P2) woman who underwent a hysteroscopy with concurrent polypectomy. The patient had no risk factors that have historically been attributed to the development of post-hysteroscopy infection, such as a history of pelvic inflammatory disease or endometriosis. The patient also had no known intra-operational complications that might predispose her to infection. Further, the patient's clinical presentation was significantly atypical. Despite having E. coli bacteremia on admission, severe abdominal pain, lack of an adequate response to several days of intravenous broad-spectrum antibiotics, and eventually evidence of abscess rupture, the patient never met clinical criteria for sepsis, including a lack of leukocytosis. This case demonstrates a rare presentation of a rare complication and emphasizes the necessity of clinical vigilance in diagnosing and promptly treating gynecological infectious complications.

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Section: Discussionmentioning

confidence: 99%