Invasive non-typeable Haemophilus influenzae infection due to endometritis associated with adenomyosis

BMC Infect Dis. 2020 Jul 16;20(1):521. doi: 10.1186/s12879-020-05193-2.

Abstract

Background: The widespread administration of the Haemophilus influenzae type b vaccine has led to the predominance of non-typable H. influenzae (NTHi). However, the occurrence of invasive NTHi infection based on gynecologic diseases is still rare.

Case presentation: A 51-year-old Japanese woman with a history of adenomyoma presented with fever. Blood cultures and a vaginal discharge culture were positive with NTHi. With the high uptake in the uterus with 67Ga scintigraphy, she was diagnosed with invasive NTHi infection. In addition to antibiotic administrations, a total hysterectomy was performed. The pathological analysis found microabscess formations in adenomyosis.

Conclusions: Although NTHi bacteremia consequent to a microabscess in adenomyosis is rare, this case emphasizes the need to consider the uterus as a potential source of infection in patients with underlying gynecological diseases, including an invasive NTHi infection with no known primary focus.

Keywords: Adenomyosis; Bacteremia; Case report; Non-typable Haemophilus influenzae; β-Lactamase-nonproducing ampicillin-resistance.

Publication types

  • Case Reports

MeSH terms

  • Adenomyosis / complications*
  • Adenomyosis / microbiology
  • Ampicillin / therapeutic use
  • Bacteremia / diagnosis
  • Bacteremia / etiology*
  • Bacteremia / microbiology
  • Bacterial Typing Techniques
  • Blood Culture
  • Drug Resistance, Multiple, Bacterial
  • Endometritis / complications*
  • Endometritis / microbiology
  • Female
  • Haemophilus Infections / blood
  • Haemophilus Infections / complications
  • Haemophilus Infections / diagnosis*
  • Haemophilus influenzae / classification
  • Haemophilus influenzae / isolation & purification*
  • Humans
  • Japan
  • Middle Aged
  • Reproductive Tract Infections / complications*
  • Reproductive Tract Infections / diagnosis
  • Reproductive Tract Infections / microbiology

Substances

  • Ampicillin