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Pyomyoma, or suppurative leiomyoma, is a rare but serious complication of uterine fibroids. The mechanism of pyomyoma is an infection caused by microorganisms coming from ascending or hematogenously on the ground of necrosis following ischemia and infarction. It can be seen during the course of pregnancy or after abortion and birth. It can also develop after uterine instrumentation or due to cervical stenosis. Patients often present with pain and fever. It should be considered in cases had no other etiology of fever and had a history of uterine fibroids. Diagnosis and treatment are often delayed due to non-specific presentation and imaging findings. This delay increases the risk of mortality and morbidity such as fertility loss. In the vast majority of these cases, total abdominal hysterectomy is required. The case we presented is a premenopausal and sexually inactive woman without any history of pregnancy or uterine instrumentation or immunocompromised. This patient is the 5th case of pyomyoma without risk factor and the 3rd case that was successfully treated with myomectomy. Knowing the proper treatment of pyomyoma will be beneficial to prevent potential mortality and morbidity.
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