The Brief Case: Mycoplasma hominis Extragenital Abscess

A 55-year-old woman with an unexplored 1-month history of rectal bleeding presented to the emergency department abdominal pain, chills, and fever. The patient had received rituximab, a monoclonal antibody targeting CD20 antigen expressed on B cells, for rheumatoid arthritis. An computed tomography (CT) scan highlighted right perirectal collection focal sigmoiditis few diverticula (Fig. 1). Owing sepsis, piperacillin-tazobactam in association gentamicin underwent early laparoscopy drain hours after initiation antimicrobial therapy. Gram staining revealed numerous polymorphonuclear leukocytes no visible microorganisms. Surgical samples blood cultures remained sterile even 5 days incubation. improvement her clinical condition. Persistent fever recurring chills along high levels inflammatory markers resulted treatment change vancomycin, cefepime, metronidazole. CT day 10 showed stable abscess. On 14, antibiotics were replaced by meropenem, amikacin, fluconazole due persistent Other sets negative. persisted explanation other than