title: A woman with diabetes presenting with pyomyoma and treated with subtotal hysterectomy: a case report.
abstract: BACKGROUND
  Pyomyoma (suppurative leiomyoma of the uterus) is a rare condition resulting from infarction and infection of a leiomyoma. It is more usual in pregnant women or postmenopausal women who have vascular disease. The condition is usually fatal unless treated with appropriate antibiotics and surgical intervention.
  
  
  METHODS
  We report a case of a 44-year-old Afro-Caribbean woman with diabetes who presented with recurrent episodes of abdominal pain and fever over a period of five months. Her problem proved to be a diagnostic dilemma mimicking cholecystitis, pyelonephritis and ovarian cancer. Her blood cultures were positive on one occasion for methicillin-resistant Staphylococcus epidermidis. An ultrasound scan suggested uterine fibroids but a computed tomography scan suggested an ovarian malignancy because the mass appeared heterogeneous with fluid filled areas. She was treated with several courses of antibiotics and eventually at laparotomy, she was found to have a large pyomyoma which was successfully removed by subtotal hysterectomy with immediate and complete resolution of her symptoms.
  
  
  CONCLUSIONS
  The diagnosis of pyomyoma should be considered in perimenopausal women with large fibroids and pyrexia of unknown origin.
authors.forename: Horace
authors.initials: H
authors.lastname: Fletcher
authors.forename: Racquel
authors.initials: R
authors.lastname: Gibson
authors.forename: Nadia
authors.initials: N
authors.lastname: Williams
authors.forename: Gilian
authors.initials: G
authors.lastname: Wharfe
authors.forename: Allison
authors.initials: A
authors.lastname: Nicholson
authors.forename: Deanne
authors.initials: D
authors.lastname: Soares