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Journal of Menopausal Medicine Dec 2020Pyometra is a very uncommon disease principally occurring in postmenopausal women. It is characterized by the accumulation of purulent material within the uterine...
Pyometra is a very uncommon disease principally occurring in postmenopausal women. It is characterized by the accumulation of purulent material within the uterine cavity. This paper presents the clinical history of a 35-year-old premenopausal woman with otherwise normal menstruation who developed heavy menstruation and was diagnosed with a benign pyometra of indeterminate etiology in March 2017. The patient underwent repeated ultrasound-guided drainage, dilation and curettage, and antibiotic therapy. Biopsies of the pelvic sidewall revealed endometriosis in June 2017. The heavy menstruation and suppurative fluid in the uterus of the patient persisted in which intramuscular leuprolide acetate was prescribed to address the endometriosis and heavy menstrual bleeding. Ultimately, the leuprolide acetate effectively resolved the patient's bleeding and pyometra. The medication was concluded after 12 months of supervision and the patient is currently symptom free. Pyometra is an unusual condition rarely identified in premenopausal women. Drainage and antibiotic therapy are routinely employed; however, one may consider gonadotropin-releasing hormone agonist medication to potentially confer a beneficial patient outcome in rare cases where endometriosis and bleeding are intractable.
PubMed: 33423406
DOI: 10.6118/jmm.20021 -
German Medical Science : GMS E-journal 2022Pyometra is a rare gynecological condition and is characterized by pus accumulation in the uterine cavity. It occurs more frequently in postmenopausal women than...
BACKGROUND
Pyometra is a rare gynecological condition and is characterized by pus accumulation in the uterine cavity. It occurs more frequently in postmenopausal women than tubo-ovarian abscesses, which constitute a more common gynecological complication among premenopausal women.
OBJECTIVE
A 72-year-old woman was admitted to our emergency department with lower abdominal pain, diarrhea and fever for the last three days. The laboratory results were indicative to sepsis. The clinical examination revealed sensitivity by palpation of the lower abdomen without any signs of acute abdomen. The gynecological assessment showed pus outflow through the cervix and a pus culture was done. The ultrasound examination found an enlarged uterus, full of hypoechoic fluid, unclear borders between endometrium-myometrium, a mixed echogenicity adnexal mass and no free fluid in the pouch of Douglas. A computed tomography (CT) of the abdomen showed the presence of pyometra and a tubo-ovarian abscess of the right adnexa.
METHOD
The patient was treated with intravenous antibiotic therapy. When the patient was hemodynamically stable and afebrile, she underwent ultrasound-guided dilatation and curettage of the cervical canal and the endometrium in order to exclude an underlying malignancy, under general anesthesia.
RESULTS
The patient responded promptly to the intravenous antibiotic therapy which was adapted to the pus culture result. The laboratory results withdrew to normal values and the patient was discharged after fifteen days of hospitalization in an afebrile and hemodynamically stable condition.
CONCLUSION
Pyometra and tubo-ovarian abscess in postmenopausal women could be a lethal complication of pelvic inflammatory disease. The key in treatment is the dilatation of the cervix and drainage of the pyometra. The administration of intravenous antibiotics and drainage through the cervix could be a suitable method of treatment for pyometra in older patients or those with poor performance status if only the histological examination is negative for malignancy.
Topics: Abdominal Abscess; Abscess; Aged; Anti-Bacterial Agents; Female; Humans; Oophoritis; Postmenopause; Pyometra; Salpingitis
PubMed: 35875245
DOI: 10.3205/000311 -
Journal of the American Veterinary... May 2022Investigate long-term complications, survival times, general health and quality of life (QoL) outcomes, and longevity in female dogs and cats (bitches and queens,...
OBJECTIVE
Investigate long-term complications, survival times, general health and quality of life (QoL) outcomes, and longevity in female dogs and cats (bitches and queens, respectively) following hospital discharge after ovariohysterectomy (OHE) for pyometra.
ANIMALS
306 pet-owner-completed surveys and corresponding medical records for 234 bitches and 72 queens treated with OHE for pyometra at the American Society for the Prevention of Cruelty to Animals Animal Hospital between January 1, 2017, and December 31, 2019.
PROCEDURES
A telephone and online survey was conducted to gather data about pet owners' perception of pet health and QoL following OHE for pyometra, and potential associations between survey results and medical record data were evaluated. Median survival time at a given age at OHE for pyometra was calculated with the use of maximum likelihood estimation of a survival-time regression model.
RESULTS
72 of the 121 (60%) eligible owners of queens and 234 of the 390 (60%) eligible owners of bitches completed the survey. Most owners reported that at the time of the survey, their pet's health and QoL were better or the same as before pyometra. Reported health and QoL outcomes were similar for pets > 8 versus ≤ 8 years of age.
CLINICAL RELEVANCE
Our findings indicated that bitches and queens undergoing OHE for pyometra at older ages and without other severe health issues can expect to live their full life span. Veterinarians in private practice could expect similar outcomes.
Topics: Animals; Cat Diseases; Cats; Dog Diseases; Dogs; Female; Hospitals; Longevity; Patient Discharge; Pyometra; Quality of Life
PubMed: 35290207
DOI: 10.2460/javma.20.12.0714 -
Journal of Proteomics Jul 2020Canine pyometra is a common inflammatory disease of uterus in sexually mature bitches caused by secondary bacterial infection, leading to change in plasma proteins...
Canine pyometra is a common inflammatory disease of uterus in sexually mature bitches caused by secondary bacterial infection, leading to change in plasma proteins associated with the innate immune system. Proteomic investigation is increasingly being applied to canine diseases in order to identify and quantify significant changes in the plasma proteome. The aim of the study was to assess and quantify changes in plasma proteome profiles of healthy dogs and pyometra affected bitches using a TMT-based high-resolution quantitative proteomic approach. As a result, 22 proteins were significantly down-regulated including transthyretin, antithrombin, retinol-binding protein, vitamin D binding protein, paraoxonase 1, and kallikrein, while 16 were significantly up-regulated including haptoglobin light chain, alpha-1-acid glycoprotein, C-reactive protein precursor, and lipopolysaccharide-binding protein in dogs with pyometra. Pathway analysis indicated that acute inflammatory response, regulation of body fluid levels, protein activation cascade, the humoral immune response, and phagocytosis were affected in pyometra. Validation of biological relevance of the proteomic study was evident with significant increases in the concentrations of haptoglobin, C-reactive protein, alpha-1-acid glycoprotein, and ceruloplasmin by immunoassay. Pyometra in bitches was shown to stimulate an increase in host defence system proteins in response to inflammatory disease including the acute phase proteins. SIGNIFICANCE: The label-based high-resolution quantitative proteomics analysis and bioinformatic approach used in this study provide insight into the complex pathophysiology of inflammation associated with pyometra revealing proteins with biomarker potential. Early diagnosis and therapeutic intervention may prevent severe complications associated with advancing sepsis in dogs with pyometra. Therefore the identification of diagnostic biomarkers that, after clinical validation may be used in veterinary practice and protein relevant to pathways responding to disease are important findings of the study. Data are available via ProteomeXchange with identifier PXD015951.
Topics: Acute-Phase Reaction; Animals; C-Reactive Protein; Dog Diseases; Dogs; Female; Humans; Proteome; Proteomics; Pyometra
PubMed: 32416315
DOI: 10.1016/j.jprot.2020.103817 -
BMC Veterinary Research Jun 2023The main aim of this report was to investigate and compare the response of serum C-reactive protein (CRP) and ferritin, two positive acute phase proteins (APPs) which...
The main aim of this report was to investigate and compare the response of serum C-reactive protein (CRP) and ferritin, two positive acute phase proteins (APPs) which usually show an increase in inflammatory processes, in dogs with pyometra. For this purpose, two different studies were made. In the first one , both proteins were measured together in an APPs profile in 25 dogs with pyometra, 25 dogs with pancreatitis (as an example of a positive inflammatory control group), and in 25 healthy dogs. In the second study, to advance the knowledge of the changes and evolution of serum ferritin and CRP in dogs with pyometra after treatment, the concentrations of both APPs were analyzed in 30 dogs with pyometra at diagnosis and after ovariohysterectomy and in 10 clinically healthy female dogs before and after elective spaying. In both studies, bitches with pyometra showed significant increases in serum CRP, indicating an inflammatory condition, but not in serum ferritin despite being a moderate positive APP. This divergence between the dynamics of these APPs could be a useful tool for the suspicion of cases of canine pyometra.
Topics: Dogs; Animals; Female; Pyometra; C-Reactive Protein; Ferritins; Hysterectomy; Dog Diseases
PubMed: 37344860
DOI: 10.1186/s12917-023-03630-3 -
Animals : An Open Access Journal From... Oct 2020Cystic endometrial hyperplasia-pyometra complex is a canine endometrial disorder, considered the most common and important among uterine diseases. The treatment of...
Cystic endometrial hyperplasia-pyometra complex is a canine endometrial disorder, considered the most common and important among uterine diseases. The treatment of choice is ovariohysterectomy, but medical treatments have become an alternative. However, no studies have been performed in order to evaluate uterine hemodynamic changes during medical treatment for pyometra bitches. Therefore, the aim of this study was to compare the effectiveness of two medical protocols by means of clinical (heart rate, respiratory rate and body temperature), medullar response (complete blood count (CBC)) and uterine hemodynamic evaluation in pyometra bitches. For such purpose, 10 bitches with pyometra were assigned to two groups: Aglepristone Group (n = 5) and Associative Group (aglepristone + prostaglandin; n = 5). The Associative Group had altered respiratory rate and decreased body temperature. The Aglepristone Group had decreased plasma protein, however, leukocyte count reduced over time for both therapeutic protocols. Uterine area and vascularization score decreased throughout treatment. There was a significant reduction in uterine perimeter, area and vascularization score. The Associative Group had lower final diastolic velocity and higher systole:diastole ratio (S/D), pulsatility index (PI) and resistance index (RI). In conclusion, both medical treatments are effective in reversing clinical and CBC changes of pyometra, especially aglepristone, however they cannot fully restore local uterine changes in a short-term evaluation. Conversely, associative therapy was more effective in decreasing uterine vascularization and modulating uterine blood flow.
PubMed: 33142944
DOI: 10.3390/ani10112011 -
Scientific Reports May 2024Despite extensive characterisation of uropathogenic Escherichia coli (UPEC) causing urinary tract infections (UTIs), the genetic background of non-urinary...
Despite extensive characterisation of uropathogenic Escherichia coli (UPEC) causing urinary tract infections (UTIs), the genetic background of non-urinary extraintestinal pathogenic E. coli (ExPEC) in companion animals remains inadequately understood. In this study, we characterised virulence traits of 104 E. coli isolated from canine pyometra (n = 61) and prostatic abscesses (PAs) (n = 38), and bloodstream infections (BSIs) in dogs (n = 2), and cats (n = 3). A stronger association with UPEC of pyometra strains in comparison to PA strains was revealed. Notably, 44 isolates exhibited resistance to third-generation cephalosporins and/or fluoroquinolones, 15 were extended-spectrum ß-lactamase-producers. Twelve multidrug-resistant (MDR) strains, isolated from pyometra (n = 4), PAs (n = 5), and BSIs (n = 3), along with 7 previously characterised UPEC strains from dogs and cats, were sequenced. Genomic characteristics revealed that MDR E. coli associated with UTIs, pyometra, and BSIs belonged to international high-risk E. coli clones, including sequence type (ST) 38, ST131, ST617, ST648, and ST1193. However, PA strains belonged to distinct lineages, including ST12, ST44, ST457, ST744, and ST13037. The coreSNPs, cgMLST, and pan-genome illustrated intra-clonal variations within the same ST from different sources. The high-risk ST131 and ST1193 (phylogroup B2) contained high numbers of ExPEC virulence genes on pathogenicity islands, predominating in pyometra and UTI. Hybrid MDR/virulence IncF multi-replicon plasmids, containing aerobactin genes, were commonly found in non-B2 phylogroups from all sources. These findings offer genomic insights into non-urinary ExPEC, highlighting its potential for invasive infections in pets beyond UTIs, particularly with regards to high-risk global clones.
Topics: Dogs; Animals; Urinary Tract Infections; Drug Resistance, Multiple, Bacterial; Male; Dog Diseases; Cats; Escherichia coli Infections; Pyometra; Abscess; Female; Cat Diseases; Uropathogenic Escherichia coli; Escherichia coli; Anti-Bacterial Agents; Prostatic Diseases; Virulence; Virulence Factors
PubMed: 38782931
DOI: 10.1038/s41598-024-62028-9 -
Microorganisms Dec 2022Despite its clinical relevance, the pathogenesis of canine pyometra remains poorly understood. To date, it is recognized as a non-transmissible infectious disease. In...
Despite its clinical relevance, the pathogenesis of canine pyometra remains poorly understood. To date, it is recognized as a non-transmissible infectious disease. In this study, the simultaneous occurrence of pyometra and in two cohabitant female dogs underwent in-depth investigation due to the hypothesis of transmission between these animals. Two 5-year-old Chow Chow dogs (namely, dogs 23 and 24-D23 and D24) were referred to a veterinary hospital with suspected pyometra. Both animals showed prostration, anorexia, and purulent vulvar discharge over a 1-week period. After ovariohysterectomy, uterine tissue, uterine contents, and rectal swabs were collected for histopathological and microbiological analysis. Uterine histology demonstrated purulent material and multifocal necrosis with endometrial ulceration, and a morphological diagnosis of pyometra was confirmed. Furthermore, from the same phylogroup (B2) and positive for the same virulence factors with the same antimicrobial susceptibility profile was isolated from the uterine contents of both dogs and the rectum of D23. Conversely, the strains recovered from D24 differed in phylogroup (one isolate), virulence factors (all three isolates), and antimicrobial susceptibility (all three isolates). Enterobacterial repetitive intergenic consensus polymerase chain reaction (ERIC-PCR) suggested that all isolates from the uterine content of both dogs and the rectal swab of D23 were 100% the same, but different from all isolates in the rectal swab of D24. One isolate from the uterine content of each animal as well as rectal swabs were subjected to whole-genome sequencing (WGS). Both whole-genome multilocus sequence typing(wgMLST) and single-nucleotide polymorphism (SNP) analysis supported the hypothesis that the isolates from the uterine content of both animals and the rectal swab of D23 were clonal. Taken together, these clinical features, pathology, microbiology, and molecular findings suggest, to the best of our knowledge, the first transmission of associated with pyometra between two animals. These results could impact the management of sites where several females cohabit in the same local area such as kennels.
PubMed: 36557718
DOI: 10.3390/microorganisms10122465 -
Veterinary World May 2021Different species of trypanosomes have been reported to cause varying degrees of reproductive disorders in pregnant and non-pregnant animals under experimental...
BACKGROUND AND AIM
Different species of trypanosomes have been reported to cause varying degrees of reproductive disorders in pregnant and non-pregnant animals under experimental infections. Information on reproductive disorders and losses in animals naturally infected with trypanosome species are few. This study was carried out to assess the abnormalities in the genital organs (ovaries, oviduct, uterus, cervix, and vagina) of female cattle naturally infected with trypanosomes in and around Abuja, Nigeria.
MATERIALS AND METHODS
Cows showing signs such as emaciation, weakness, or anemia were selected and examined at Gwagwalada and Karu abattoirs, respectively. Venous blood samples were taken from 108 of such animals and screened using standard trypanosome detection methods. The genital organs were also collected and inspected for gross and histopathological lesions in the laboratory.
RESULTS
Six (5.55%) out of the 108 animals were positive for trypanosomes; 4 (66.7%) were infected with and 2 (33.3%) were infected with . The mean packed cell volume of the infected animals was 22.83%. Grossly, congestion and ecchymotic hemorrhages were observed in the endometrium, myometrium, and cervical submucosa. Mucometra, hydrometra, and pyometra were also seen in the uterus. Histologically, necrosis of the epithelium and endometrial glands accompanied by mononuclear cellular infiltration was observed in the uterus. There was also sloughing of the endometrial epithelium, vascular congestion, and hypertrophy of serosa of the uterus. There was atropy of the granulosa cells, increased numbers of degenerating tertiary follicles, and absence of corpora lutea in the ovary. No gross or histopathological lesions were observed in the fallopian tube and vagina.
CONCLUSION
The lesions observed were restricted to the uterus and ovary of the animals and were less severe when compared to lesions observed under experimental conditions as reported by previous authors.
PubMed: 34220142
DOI: 10.14202/vetworld.2021.1363-1370 -
Brazilian Journal of Veterinary Medicine 2022This randomized clinical trial aimed to evaluate different fluid therapy protocols associated with inhalational or total intravenous anesthesia in the cardiorespiratory...
This randomized clinical trial aimed to evaluate different fluid therapy protocols associated with inhalational or total intravenous anesthesia in the cardiorespiratory stability of bitches with sepsis subjected to a surgical procedure to control the infectious focus. Thirty-two bitches diagnosed with pyometra and sepsis and treated at the University Veterinary Hospital between 2018 and 2019 were recruited. After admission, diagnosis, clinical, and laboratory evaluation, patients were randomly distributed into the following groups: propofol 5 (P[5]: preoperative restrictive fluid therapy-5mL/kg/h and intravenous general anesthesia); propofol 10 (P[10]: preoperative liberal fluid therapy-10mL/kg/h and intravenous general anesthesia); and isoflurane 5 (I[5]: preoperative restrictive fluid therapy-5mL/kg/h and inhalational general anesthesia). Lactate on admission (LAC1) and release (LAC2), heart rate (HR), respiratory rate (RR), systolic blood pressure (SBP), rectal temperature (RT), oxygen saturation (SpO), and carbon dioxide extraction rate (EtCO) were analyzed at PRE, T10, T20, T30, T40, T50, TEXT, and TDIS. Clearance of 20% of lactate occurred in 18 dogs, with the P[10] group displaying the best performance. There was no statistical difference in vasopressor requirements among the groups. Liberal fluid therapy showed greater cardiovascular stability than restrictive therapy in the perioperative period. Regarding general anesthesia, isoflurane showed greater cardiorespiratory stability than propofol during anesthetic maintenance. In conclusion, although the three proposed protocols are safe and there is no difference in their superiority, some observed changes may be relevant and considered when it is possible to individualize the therapy for the patient.
PubMed: 36128403
DOI: 10.29374/2527-2179.bjvm001222