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Re: Pyometra From: Garry E. Siegel, M.D. (garrys@mindspring.com) Wed Jun 29 20:49:03 2005 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: R. Daniel Braun: "Re: Circlage at 30 wks" Previous message: Dr. Ainsworth: "Pyometra" In reply to: Dr. Ainsworth: "Pyometra" Next in thread: Dr. Ainsworth: "Re: Pyometra" Reply: Dr. Ainsworth: "Re: Pyometra" Good case. Why not treat, and then rescan for endometrial thickness? If thin and no bleeding, then the likelihood of an anatomic abnormality is low. Level of Evidence--SOP-BS (seat of pants, and you know what BS stands for :)). At Wed, 29 Jun 2005, Dr. Ainsworth wrote: > >I saw a pleasant 82 yo widowed-lady last week. She is not sexually >active and was referred because of "recurrent vaginal spotting" over the >past two years. No other complaints, in fact she didn't even feel she >had a problem, takes no meds, no health problems. Her FP ordered a >sonogram before I saw her that showed fluid within the endometrial >cavity and possibly a 12mm polyp. I suggested an endometrial biopsy >which she reluctantly agreed to. When I introduced the pipelle, which >slid in without resistance, much to my suprise, it filled quickly with >purulent material. I replaced it with an explorer curette and the >syringe filled with 8 cc of pus and was blood tinged. Pathology came >back benign with mucopurelent material. The culture showed diphtheroids >and enterococcus. I placed her on Doxycycline at the time of the >biopsy, when the culture and sensitivity came back the only thing it was >sensitive to was Vancomycin. My plan is to finish the current >antibiotics and repeat the sonogram in a month. Does anyone feel that a >hysteroscopy is necessary at this point? Any ideas on why she would >present with this unusual finding? -- Garry E. Siegel, M.D. Private Practice Roswell, GA Next message: R. Daniel Braun: "Re: Circlage at 30 wks" Previous message: Dr. Ainsworth: "Pyometra" In reply to: Dr. Ainsworth: "Pyometra" Next in thread: Dr. Ainsworth: "Re: Pyometra" Reply: Dr. Ainsworth: "Re: Pyometra"

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