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Re: Pyometra From: Andrew Folley (agfolley@hotmail.com) Thu Jun 30 08:57:20 2005 Messages sorted by: [ date ][ thread ][ subject ][ author ] Previous message: ainsron: "Re: Pyometra" In reply to: Dr. Ainsworth: "Pyometra" Other things to think about besides the obvious endo ca. Consider degeneration of submucsoal fibriod or polyp. This pyometira may have been there for years. Foriegn body another possiblilty dont ask me how. If she is in relatively good health I think a hysteroscopy D&C would be most appropriate. You could give her a dose of vancomycin 1 gram IV at that time as well and expect some serious facial and skin flushing. Make sure fallowpian tubes were normal. Hydrops Tubae Profluens is characteristic of fallopian tube ca. I ma betting on necrotic polyp which led to this but my second bet is on the endometrial ca. andrew >From: ainsron@sbcglobal.net (Dr. Ainsworth) >Reply-To: ob-gyn-l@obgyn.net >To: Multiple recipients of list OB-GYN-L <ob-gyn-l@dns.obgyn.net> >Subject: Pyometra >Date: Wed, 29 Jun 2005 20:11:52 -0500 > >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? > Previous message: ainsron: "Re: Pyometra" In reply to: Dr. Ainsworth: "Pyometra"

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