Iliopsoas abscess: an unexpected sequela of dilation and evacuation.

OBJECTIVE: This study aimed to report the case of a patient who developed an iliopsoas abscess after a dilation and evacuation for a midtrimester fetal demise. MATERIALS AND METHODS: This is a case report of a 35-year-old woman who underwent a dilation and evacuation at 17 weeks' gestation because of a preterm premature rupture of membranes and fetal demise. Four days later, she presented with fevers, chills, malaise, and right lower back, hip, and thigh pain. Magnetic resonance imaging of the abdomen and pelvis revealed a 2.3 × 1.6-cm right iliopsoas abscess. RESULTS: The patient underwent computed tomography-guided drainage of the abscess and made an uneventful recovery after completion of an antibiotic course and physical therapy. CONCLUSIONS: An iliopsoas abscess should be considered in the differential diagnosis of any woman presenting with fevers, chills, and unilateral lower back, hip, and thigh pain in a radicular pattern after a recent dilation and evacuation.

Arteriovenous malformation of the vulva: a case report.

OBJECTIVE: To report the case of a patient with a large and symptomatic vulvar lesion, necessitating surgical excision. CASE: We report the case of a 57-year-old postmenopausal woman with a 6-month history of an enlarging vulvar lesion associated with vulvar pruritus. On examination, a pedunculated 7 × 5 × 4-cm soft tissue mass attached to the left labium majus was noted. Surgical excision was performed and histopathologic evaluation revealed variably dilated, submucosal vessels with thick muscular walls and intimal thickening, but without endothelial atypia or multilayering. These findings were consistent with a final diagnosis of arteriovenous malformation of the vulva. CONCLUSIONS: Given the complex anatomy of the vulva, the differential diagnosis for vulvar vascular lesions can be challenging. Hence, surgical excision and histopathologic evaluation become imperative to distinguish them from other dermatologic and neoplastic conditions of the vulva.

Vaginorectal Streptococcus porcinus in pregnancy: an emerging pathogen?

OBJECTIVE: Streptococcus porcinus has previously been isolated from the genitourinary tract of reproductive-aged women. However, very little is known about the pathogenicity of this microorganism in pregnancy. The study aimed to report pregnancies complicated by vaginorectal S. porcinus and associated adverse outcomes. MATERIALS AND METHODS: We present 2 patients with 3 pregnancies complicated by vaginorectal S. porcinus and preterm cervical change. RESULTS: The first patient lost a twin pregnancy to previable preterm rupture of membranes. During her subsequent pregnancy, again positive for S. porcinus, cervical shortening prompted antibiotic treatment and cerclage. The second patient delivered preterm despite cerclage placed for sonographic indications. CONCLUSIONS: Our cases suggest that S. porcinus may contribute to the pathogenesis of preterm rupture of membranes and cervical insufficiency.