[Bacteroides fragilis in anaerobic infection with bacteremia following total hysterectomy]. / Bacteroides fragilis pri anaerobna infektsiia s bakteriemiia sled totalna khisterektomiia.

PIP: The role of Bacteroides fragilis in the etiology of gynecological infections is illustrated by a case history of a 49-year old woman. The patient was seen for removal of a Super-Dana IUD inserted 10 years prior to the present admission. Gynecological examination indicated enlargement of the uterus and myomatous nodule in the anterior wall. The patient underwent typical total hysterectomy with bilateral adnexectomy. Histological examination of the surgical specimen showed uterine leiomyoma, proliferative endometrium, and a focus of subserous hemorrhage. Postoperatively, the patient was given the antibiotic tetraolean (100 mg, 4 times/day, for 5 days). On day 8 after the surgery, the patient rapidly developed clinical manifestations of sepsis. Vaginal examination showed mild infiltration of the parametrium and greenish-bluish putrid exudate. With provisional diagnosis of anaerobic-aerobic infection, the patient was given combined antibiotics. Bacteriological culturing of a specimen from vaginal exudate indicated the presence of Bacteroides fragilis. The patient received antibacterial therapy for 10 days, and was discharged in good condition. These findings illustrate the possibility of development of postoperative Bacteroides infection in patients with inserted IUD.^ieng