Korean J Obstet Gynecol.  2012 Jun;55(6):429-432. 10.5468/KJOG.2012.55.6.429.

A case of postmenopausal pyometra caused by endometrial tuberculosis

• Lee DH
• Cho DH
• Lee JH
• Kim YR

• KMID: 1783938
• DOI: http://doi.org/10.5468/KJOG.2012.55.6.429

Abstract

Mycobacterium infection manifesting pyometra in postmenopausal women is a extremely rare disease that hardly responds to the usual treatment of pus drainage and antibiotics therapy. We present a case of a postmenopausal woman with pyometra caused by endometrial tuberculosis. Almost all of the pus could be drained through the stenotic cervical canal, with difficultly. The result of Pipelle endometrial biopsy was negative. However, her symptoms continued and fluid gradually re-accumulated in the uterine cavity, despite successful pus drainage and sufficient antibiotics use. Therefore, the endometrial tissue was obtained by fractional curettage after cervical dilatation to identify the accurate cause of pyometra. A pathologic examination and polymerase chain reaction confirmed the diagnosis of endometrial tuberculosis. After completion of antituberculous medication, she was doing well without further development of pyometra. In a case of postmenopausal pyometra, endometrial sampling should be performed to rule out endometrial tuberculosis.

Keyword

Postmenopausal; Pyometra; Endometrial tuberculosis

MeSH Terms

Anti-Bacterial Agents
Biopsy
Curettage
Drainage
Female
Humans
Labor Stage, First
Mycobacterium Infections
Polymerase Chain Reaction
Pregnancy
Pyometra
Rare Diseases
Suppuration
Tuberculosis
Anti-Bacterial Agents

Figure

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  Fig. 1 A 77-year-old woman diagnosed with pyometra caused by endometrial tuberculosis. (A) Transvaginal pelvic ultrasound and (B) contrast-enhanced abdominal computed tomography show a collection of fluid in the dilated uterine cavity, without any suspicious malignant lesions.

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  Fig. 2 (A) Endometrial tissue shows granuloma composed of epithelioid cells with Langerhans' cells (H&E, ×100). (B) Endometrial tissue is positive for polymerase chain reaction for Mycobacterium tuberculosis (right lane).

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