Pyomyoma

Pyomyoma

Overview

Pyomyoma, also known as suppurative leiomyoma, is a rare complication of uterine leiomyomas, commonly referred to as fibroids. It occurs when a leiomyoma undergoes infection and subsequent suppuration, leading to the formation of pus within the fibroid tissue. This condition can result in significant clinical symptoms and requires prompt medical attention.

Pathophysiology

Pyomyoma develops when a uterine fibroid becomes infected, often due to bacterial invasion. The infection can arise from various sources, including the spread of bacteria from the uterine cavity, bloodstream, or adjacent pelvic structures. The presence of necrotic tissue within the fibroid can predispose it to infection, leading to the accumulation of pus and the formation of an abscess.

Clinical Presentation

Patients with pyomyoma may present with a range of symptoms, including:

• Severe abdominal or pelvic pain
• Fever and chills
• Leukocytosis (elevated white blood cell count)
• Vaginal discharge
• Abdominal distension

The symptoms can mimic other pelvic or abdominal conditions, making diagnosis challenging.

Diagnosis

The diagnosis of pyomyoma is often based on clinical suspicion, supported by imaging studies. Ultrasound and computed tomography (CT) scans can help identify the presence of a mass with characteristics suggestive of infection, such as irregular borders and fluid collections. Magnetic resonance imaging (MRI) may also be used to provide detailed information about the lesion.

Treatment

The management of pyomyoma typically involves a combination of antibiotic therapy and surgical intervention. Broad-spectrum antibiotics are administered to address the underlying infection. Surgical options may include:

• Myomectomy: Surgical removal of the infected fibroid
• Hysterectomy: Removal of the uterus, which may be necessary in severe cases or when fertility preservation is not a concern

Prompt treatment is essential to prevent complications such as sepsis or peritonitis.

Prognosis

With appropriate treatment, the prognosis for patients with pyomyoma is generally favorable. However, delayed diagnosis or treatment can lead to serious complications, underscoring the importance of early intervention.

See Also

• Leiomyoma
• Uterine fibroid
• Pelvic inflammatory disease