PDF(Pubmed)
Abstract：
BACKGROUND: Streptococcus pneumoniae infrequently causes genital tract infections but - in particular predisposing circumstances - it can be a transient part of vaginal flora and thus pelvic infections can occur. Possible conditions associated with pneumococcal pelvic-peritonitis include the use of intrauterine contraceptive devices, recent birth and gynecologic surgery. The underlying mechanism of these occurrences is likely to be the ascending infection from the genital tract via the fallopian tubes.
METHODS: We present a case of pelvic-peritonitis and pneumonia due to Streptococcus pneumoniae in a healthy young woman wearing a menstrual endovaginal cup. Following the radiological findings of a cystic formation in the right ovary and ascites effusions in all peritoneal recesses an emergency exploratory laparoscopy with right ovariectomy was performed. After resolution of abdominal sepsis, parenchymal consolidation complicated into necrotizing pneumonia, hence the patient underwent a right lower lobectomy.
CONCLUSIONS: The menstrual cup is a self-retaining intravaginal menstrual fluid collection device, considered as a safe alternative to tampons and pads, which use is associated with rare adverse effects. Few cases of infectious disease have been described, where the underlying mechanism may consist of bacterial replication within the blood accumulated in the uterine environment, with subsequent ascension into the genital tract.
CONCLUSIONS: In the rare occurrence of pneumococcal pelvic-peritonitis considering all possible infectious sources is paramount, as is assessing the possible involvement of intravaginal devices, increasingly used nowadays but of which potential complications are still poorly described.
METHODS: We present a case of pelvic-peritonitis and pneumonia due to Streptococcus pneumoniae in a healthy young woman wearing a menstrual endovaginal cup. Following the radiological findings of a cystic formation in the right ovary and ascites effusions in all peritoneal recesses an emergency exploratory laparoscopy with right ovariectomy was performed. After resolution of abdominal sepsis, parenchymal consolidation complicated into necrotizing pneumonia, hence the patient underwent a right lower lobectomy.
CONCLUSIONS: The menstrual cup is a self-retaining intravaginal menstrual fluid collection device, considered as a safe alternative to tampons and pads, which use is associated with rare adverse effects. Few cases of infectious disease have been described, where the underlying mechanism may consist of bacterial replication within the blood accumulated in the uterine environment, with subsequent ascension into the genital tract.
CONCLUSIONS: In the rare occurrence of pneumococcal pelvic-peritonitis considering all possible infectious sources is paramount, as is assessing the possible involvement of intravaginal devices, increasingly used nowadays but of which potential complications are still poorly described.
摘要：
背景：肺炎链球菌很少引起生殖道感染，但特别是在易感的情况下，它可能是阴道菌群的短暂部分，因此可能发生盆腔感染。与肺炎球菌性盆腔腹膜炎相关的可能病症包括使用宫内节育器，最近的分娩和妇科手术。这些事件的潜在机制可能是通过输卵管从生殖道上升感染。
方法：我们介绍了一个健康的年轻女性，戴着月经阴道内杯，由肺炎链球菌引起的盆腔腹膜炎和肺炎。放射学发现右卵巢囊性形成和所有腹膜腔腹水积液后，进行了紧急探查腹腔镜检查和右卵巢切除术。腹部败血症消退后，实质巩固并发坏死性肺炎，因此患者接受了右下肺叶切除术。
结论：月经杯是一种自保留的阴道内月经液收集装置，被认为是卫生棉条和护垫的安全替代品，使用与罕见的不良反应有关。很少有传染病病例被描述，其中潜在的机制可能包括细菌在子宫环境中积累的血液中复制，随后进入生殖道。
结论：在罕见的肺炎球菌性盆腔腹膜炎中，考虑到所有可能的感染源是至关重要的，就像评估阴道内装置的可能参与一样，如今越来越多地使用，但其中潜在的并发症仍然描述不佳。
方法：我们介绍了一个健康的年轻女性，戴着月经阴道内杯，由肺炎链球菌引起的盆腔腹膜炎和肺炎。放射学发现右卵巢囊性形成和所有腹膜腔腹水积液后，进行了紧急探查腹腔镜检查和右卵巢切除术。腹部败血症消退后，实质巩固并发坏死性肺炎，因此患者接受了右下肺叶切除术。
结论：月经杯是一种自保留的阴道内月经液收集装置，被认为是卫生棉条和护垫的安全替代品，使用与罕见的不良反应有关。很少有传染病病例被描述，其中潜在的机制可能包括细菌在子宫环境中积累的血液中复制，随后进入生殖道。
结论：在罕见的肺炎球菌性盆腔腹膜炎中，考虑到所有可能的感染源是至关重要的，就像评估阴道内装置的可能参与一样，如今越来越多地使用，但其中潜在的并发症仍然描述不佳。
