title: Postpartum fever in the presence of a fibroid: Sphingomonas paucimobilis sepsis associated with pyomyoma.
abstract: BACKGROUND
  Pyomyoma is a life-threatening complication of uterine leiomyoma. It may occur in post- menopausal women, during pregnancy and in the postpartum period. Fever may be the only manifestation during the early stages of the disease. We detail the first reported case of postpartum pyomyoma-related sepsis due to Sphingomonas paucimobilis, a Gram-negative bacillus that is gaining recognition as an important human pathogen.
  
  
  METHODS
  A woman presented with an asymptomatic uterine fibroid and a two-week history of fever during the postpartum period. Suppurative uterine leiomyoma was diagnosed, and blood cultures grew Sphingomonas paucimobilis. The myoma was surgically removed from the uterus without hysterectomy. Intravenous antimicrobial therapy was given for fifteen days, and the patient was discharged from hospital in good condition.
  
  
  CONCLUSIONS
  Pyomyoma should be considered in broad differential diagnosis of postpartum fever. This case highlights a unique disease manifestation of S. paucimobilis, an emerging opportunistic pathogen with increasing significance in the nosocomial setting.
authors.affiliation: Infectious Disease Unit, Fondazione Eleonora Lorillard Spencer Cenci, Sapienza University, Corso Della Repubblica 79, 04100 Latina, Italy. claudio.mastroianni@uniroma1.it.
authors.forename: Cosmo
authors.initials: C
authors.lastname: Del Borgo
authors.forename: Francesco
authors.initials: F
authors.lastname: Maneschi
authors.forename: Valeria
authors.initials: V
authors.lastname: Belvisi
authors.forename: Francesca
authors.initials: F
authors.lastname: Morelli
authors.forename: Angelo
authors.initials: A
authors.lastname: Vetica
authors.forename: Raffaella
authors.initials: R
authors.lastname: Marocco
authors.forename: Tiziana
authors.initials: T
authors.lastname: Tieghi
authors.forename: Miriam
authors.initials: M
authors.lastname: Lichtner
authors.forename: Claudio M
authors.initials: CM
authors.lastname: Mastroianni
mesh_terms: D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D005260:Female; D005334:Fever / Q000188:drug therapy / Q000209:etiology / Q000382:microbiology* / Q000601:surgery; D016905:Gram-Negative Bacterial Infections / Q000188:drug therapy / Q000209:etiology / Q000382:microbiology* / Q000601:surgery; D006801:Humans; D007889:Leiomyoma / Q000150:complications / Q000188:drug therapy / Q000382:microbiology* / Q000601:surgery; D049590:Postpartum Period; D011247:Pregnancy; D018805:Sepsis / Q000188:drug therapy / Q000209:etiology / Q000382:microbiology*; D020578:Sphingomonas / Q000302:isolation & purification / Q000502:physiology*
chemical_list: D000900:Anti-Bacterial Agents