子宫颈癌子宫切除术后由副溶脲原体引起的阴道袖口感染:病例报告。

IF 1 Q4 INFECTIOUS DISEASES Case Reports in Infectious Diseases Pub Date : 2024-10-21 eCollection Date: 2024-01-01 DOI:10.1155/2024/4114954
Hayato Chikamatsu, Mana Taki, Sachiko Kitamura, Masumi Sunada, Koji Yamanoi, Ryusuke Murakami, Ken Yamaguchi, Akihito Horie, Yasuhiro Tsuchido, Junzo Hamanishi, Masaki Mandai
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引用次数: 0

摘要

解脲支原体是泌尿生殖道最常见的地方性支原体之一,可引起羊水感染,导致早产。我们报告了一例罕见的子宫切除术后副脲原体感染从阴道上升至腹腔,导致阴道袖带感染、术后腹膜炎和小肠梗阻的病例。一名 29 岁的无子宫妇女因感染子宫颈癌而就诊。子宫颈癌根治性切除术后,患者出现麻痹性回肠炎、腹水和发烧。怀疑是腹膜炎,但所有培养结果均为阴性,因此难以确定致病菌。腹水中的聚合酶链反应(PCR)发现了副脲原体,可以用左氧氟沙星(LVFX)治疗。为控制感染而进行的开放引流显示,阴道袖带周围有坏死组织,小肠被蚕茧状纤维包裹,如同硬化性包裹性腹膜炎。感染好转后,肠梗阻也有所改善。解脲支原体很难培养。当怀疑容易发生机会性感染的患者(如恶性肿瘤患者)出现泌尿生殖系统感染时,应考虑进行尿解支原体感染的 PCR 检测。
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Vaginal Cuff Infection Caused by Ureaplasma parvum After Hysterectomy for Uterine Cervical Cancer: A Case Report.

Ureaplasma parvum is one of the most common endemic mycoplasmas in the genitourinary tract and can cause amniotic fluid infection leading to preterm labor. We report a rare case of Ureaplasma parvum infection ascending from the vagina to the abdominal cavity after hysterectomy, causing vaginal cuff infection, postoperative peritonitis, and small bowel obstruction. A 29-year-old nulliparous woman presented with infected uterine cervical cancer. After radical hysterectomy for uterine cervical cancer, the patient had paralytic ileus with ascites and fever. Peritonitis was suspected; however, all cultures were negative, making it difficult to identify the causative organism. Polymerase chain reaction (PCR) of the ascites revealed Ureaplasma parvum, which could be treated with levofloxacin (LVFX). Open drainage to control the infection revealed a necrotic tissue around vaginal cuff and the small intestine encased in cocoon-like fibers like sclerosing encapsulating peritonitis. After the infection was improved, the bowel obstruction was also improved. Ureaplasma spp. can be difficult to culture. PCR testing for Ureaplasma infection should be considered when urogenital infection is suspected in patients prone to opportunistic infections, such as those with malignant tumors.

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