Septic shock in a woman with a hydatidiform mole: A case report

Hydatidiform moles can be fatal because of the risk of massive bleeding or thyroid storm; however, they rarely occur concomitantly with sepsis. We present herein the case of a woman with a hydatidiform mole with septic shock. A 30-year-old multiparous woman with Basedow's disease presented with...

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Main Authors: Yuki Yoshimoto, Tsuyoshi Murata, Moeko Machida, Yoshihiro Nozawa, Soichi Nakamura, Ryuji Yamauchi
Format: Article
Language:English
Published: Elsevier 2022-07-01
Series:Case Reports in Women's Health
Subjects:
Online Access:http://www.sciencedirect.com/science/article/pii/S2214911222000376
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author Yuki Yoshimoto
Tsuyoshi Murata
Moeko Machida
Yoshihiro Nozawa
Soichi Nakamura
Ryuji Yamauchi
author_facet Yuki Yoshimoto
Tsuyoshi Murata
Moeko Machida
Yoshihiro Nozawa
Soichi Nakamura
Ryuji Yamauchi
author_sort Yuki Yoshimoto
collection DOAJ
description Hydatidiform moles can be fatal because of the risk of massive bleeding or thyroid storm; however, they rarely occur concomitantly with sepsis. We present herein the case of a woman with a hydatidiform mole with septic shock. A 30-year-old multiparous woman with Basedow's disease presented with fever, amenorrhea, and vaginal bleeding. Transvaginal ultrasonography revealed an enlarged uterus with an intrauterine vesicular mass (74.3 × 93.0 mm). Human chorionic gonadotropin level was 994,000 mIU/mL. C-reactive protein was elevated, and blood cultures were positive (gram-negative rods), indicating infection. After administering antibiotics (tazobactam and piperacillin), blood pressure suddenly decreased (69/45 mmHg), requiring stabilization with noradrenaline and albumin. The uterine contents were naturally expelled, followed by dilatation and curettage after her vital signs and general condition gradually improved. The pathological diagnosis was a complete hydatidiform mole. Culture of the intrauterine contents revealed Escherichia coli, leading to the potentially fatal diagnosis of septic shock associated with a hydatidiform mole.
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spelling doaj.art-7e6027ec451a4d339ca157b516fa15bd2022-12-22T02:49:24ZengElsevierCase Reports in Women's Health2214-91122022-07-0135e00417Septic shock in a woman with a hydatidiform mole: A case reportYuki Yoshimoto0Tsuyoshi Murata1Moeko Machida2Yoshihiro Nozawa3Soichi Nakamura4Ryuji Yamauchi5Department of Obstetrics and Gynecology, Shirakawa Kosei General Hospital, 2-1 Toyochi Kamiyajiro, Shirakawa, Fukushima 961-0005, Japan; Corresponding author.Department of Obstetrics and Gynecology, Shirakawa Kosei General Hospital, 2-1 Toyochi Kamiyajiro, Shirakawa, Fukushima 961-0005, JapanDepartment of General Medicine, Shirakawa Kosei General Hospital, 2-1 Toyochi Kamiyajiro, Shirakawa, Fukushima 961-0005, JapanDepartment of Diagnostic Pathology, Shirakawa Kosei General Hospital, 2-1 Toyochi Kamiyajiro, Shirakawa, Fukushima 961-0005, JapanDepartment of Obstetrics and Gynecology, Shirakawa Kosei General Hospital, 2-1 Toyochi Kamiyajiro, Shirakawa, Fukushima 961-0005, JapanDepartment of Obstetrics and Gynecology, Shirakawa Kosei General Hospital, 2-1 Toyochi Kamiyajiro, Shirakawa, Fukushima 961-0005, JapanHydatidiform moles can be fatal because of the risk of massive bleeding or thyroid storm; however, they rarely occur concomitantly with sepsis. We present herein the case of a woman with a hydatidiform mole with septic shock. A 30-year-old multiparous woman with Basedow's disease presented with fever, amenorrhea, and vaginal bleeding. Transvaginal ultrasonography revealed an enlarged uterus with an intrauterine vesicular mass (74.3 × 93.0 mm). Human chorionic gonadotropin level was 994,000 mIU/mL. C-reactive protein was elevated, and blood cultures were positive (gram-negative rods), indicating infection. After administering antibiotics (tazobactam and piperacillin), blood pressure suddenly decreased (69/45 mmHg), requiring stabilization with noradrenaline and albumin. The uterine contents were naturally expelled, followed by dilatation and curettage after her vital signs and general condition gradually improved. The pathological diagnosis was a complete hydatidiform mole. Culture of the intrauterine contents revealed Escherichia coli, leading to the potentially fatal diagnosis of septic shock associated with a hydatidiform mole.http://www.sciencedirect.com/science/article/pii/S2214911222000376Hydatidiform moleSepsisSeptic shockVesicular patternUltrasound
spellingShingle Yuki Yoshimoto
Tsuyoshi Murata
Moeko Machida
Yoshihiro Nozawa
Soichi Nakamura
Ryuji Yamauchi
Septic shock in a woman with a hydatidiform mole: A case report
Case Reports in Women's Health
Hydatidiform mole
Sepsis
Septic shock
Vesicular pattern
Ultrasound
title Septic shock in a woman with a hydatidiform mole: A case report
title_full Septic shock in a woman with a hydatidiform mole: A case report
title_fullStr Septic shock in a woman with a hydatidiform mole: A case report
title_full_unstemmed Septic shock in a woman with a hydatidiform mole: A case report
title_short Septic shock in a woman with a hydatidiform mole: A case report
title_sort septic shock in a woman with a hydatidiform mole a case report
topic Hydatidiform mole
Sepsis
Septic shock
Vesicular pattern
Ultrasound
url http://www.sciencedirect.com/science/article/pii/S2214911222000376
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