Postpartum endometritis caused by herpes and cytomegaloviruses

Obstet Gynecol. 2011 Feb;117(2 Pt 2):466-7. doi: 10.1097/AOG.0b013e3181f73805.

Abstract

Background: Postpartum endometritis is usually a polymicrobial infection caused by organisms that are part of the normal vaginal flora. A pathologically confirmed case of postpartum endometritis secondary to herpes and cytomegalovirus in a human immunodeficiency virus (HIV)-positive patient is reported.

Case: A 29-year-old, HIV-positive woman presented 6 days postpartum with abdominal pain and foul-smelling vaginal discharge. Pelvic ultrasonography revealed retained products of conception. Dilation and evacuation was performed, and antibiotics were started. Despite adequate antibiotics and laparoscopic drainage of a pelvic collection, fevers and pain continued. A total abdominal hysterectomy, salpingectomy, and appendectomy were performed. Pathology reported herpes and cytomegalovirus infection of the uterus.

Conclusion: Herpes simplex virus (HSV) and cytomegalovirus need to be considered as a potential cause of postpartum endometritis. When antibiotic therapy fails, an antiviral regimen should be considered.

Publication types

  • Case Reports

MeSH terms

  • AIDS-Related Opportunistic Infections / drug therapy
  • AIDS-Related Opportunistic Infections / pathology
  • AIDS-Related Opportunistic Infections / surgery
  • AIDS-Related Opportunistic Infections / virology*
  • Abdominal Pain / virology
  • Adult
  • Anti-Bacterial Agents / therapeutic use
  • Antiviral Agents / therapeutic use
  • Appendectomy
  • Cytomegalovirus Infections / complications*
  • Cytomegalovirus Infections / pathology
  • Drainage / methods
  • Endometritis / drug therapy
  • Endometritis / pathology
  • Endometritis / surgery
  • Endometritis / virology*
  • Female
  • Fever / drug therapy
  • Fever / surgery
  • Herpes Simplex / complications*
  • Herpes Simplex / pathology
  • Humans
  • Hysterectomy
  • Pelvis / diagnostic imaging
  • Pelvis / virology
  • Puerperal Disorders / drug therapy
  • Puerperal Disorders / pathology
  • Puerperal Disorders / surgery
  • Puerperal Disorders / virology*
  • Salpingectomy
  • Ultrasonography
  • Vaginal Discharge / virology

Substances

  • Anti-Bacterial Agents
  • Antiviral Agents