A Case of Postmenopausal Pyometra Caused by Endometrial Tuberculosis

Mycobacterium infection manifesting pyometra in postmenopausal women is a extremely rare disease that hardly responds to the usual treatment of pus drainage and antibiotics therapy. We present a case of a postmenopausal woman with pyometra caused by endometrial tuberculosis. Almost all of the pus could be drained through the stenotic cervical canal, with diffi cultly. The result of Pipelle endometrial biopsy was negative. However, her symptoms continued and fl uid gradually re-accumulated in the uterine cavity, despite successful pus drainage and suffi cient antibiotics use. Therefore, the endometrial tissue was obtained by fractional curettage after cervical dilatation to identify the accurate cause of pyometra. A pathologic examination and polymerase chain reaction confi rmed the diagnosis of endometrial tuberculosis. After completion of antituberculous medication, she was doing well without further development of pyometra. In a case of postmenopausal pyometra, endometrial sampling should be performed to rule out endometrial tuberculosis.