Postpartum endometritis caused by herpes and cytomegaloviruses.
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.


METHODS
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.


CONCLUSIONS
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.
From the Department of Obstetrics and Gynecology, Thomas Jefferson University, Philadelphia, Pennsylvania; and the Department of Obstetrics and Gynecology, Albert Einstein Medical Center, Philadelphia, Pennsylvania.
Maria A
MA
Giraldo-Isaza
David
D
Jaspan
Arnold W
AW
Cohen
D017088:AIDS-Related Opportunistic Infections / Q000188:drug therapy / Q000473:pathology / Q000601:surgery / Q000821:virology*; D015746:Abdominal Pain / Q000821:virology; D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000998:Antiviral Agents / Q000627:therapeutic use; D001062:Appendectomy; D003586:Cytomegalovirus Infections / Q000150:complications* / Q000473:pathology; D004322:Drainage / Q000379:methods; D004716:Endometritis / Q000188:drug therapy / Q000473:pathology / Q000601:surgery / Q000821:virology*; D005260:Female; D005334:Fever / Q000188:drug therapy / Q000601:surgery; D006561:Herpes Simplex / Q000150:complications* / Q000473:pathology; D006801:Humans; D007044:Hysterectomy; D010388:Pelvis / Q000000981:diagnostic imaging / Q000821:virology; D011644:Puerperal Disorders / Q000188:drug therapy / Q000473:pathology / Q000601:surgery / Q000821:virology*; D058994:Salpingectomy; D014463:Ultrasonography; D019522:Vaginal Discharge / Q000821:virology
D000900:Anti-Bacterial Agents; D000998:Antiviral Agents
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