Acute Sepsis Following Cervical Biopsy for Uterine Tumor: A Case Study

The patient developed acute sepsis following a cervical biopsy due to uterine tumors?

An elderly family member has a tumor in the uterus, and the hospital arranged for a biopsy.
After the biopsy, the patient fainted and developed a fever while waiting outside the examination room.
Upon transfer to the emergency department, it was diagnosed as acute sepsis, and that night the patient was moved to the intensive care unit.
Today marks the sixth day, and the physician reported that bacteria found in the urine culture were present during previous tests.
Antibiotics have been administered targeting this bacteria, but other sources of infection have not yet been identified.
The patient remains in a comatose state, is intubated, has low blood pressure managed with machines and medications, is experiencing edema, had previous bleeding which has now ceased, and is unable to urinate, requiring dialysis.
Other organs are also showing signs of failure.
I would like to ask a few questions:
1.
Are there any other diagnostic methods available to help identify the source of infection? We are willing to pay out of pocket rather than wait for the slow process of the national health insurance system.

2.
Is it true that antibiotics can only be used for 7 days? Today is the fifth day, and if no other bacteria are found, what should be done after the 7-day period?
3.
Have there been any documented cases of biopsy leading to acute sepsis? Thank you!

Alan, 50~59 year old female. Ask Date: 2024/03/20

Dr. Cao Guotao reply Obstetrics and Gynecology

Hello, it is rare for acute sepsis to occur due to a biopsy.
It is possible that your elder's age and weakened immune system could be contributing factors, but that remains uncertain.
Currently, the main issue seems to be internal medicine-related, and I am unable to assist further.
It would be more appropriate to discuss this with the attending physician.
Wishing you good health.

Reply Date: 2024/03/20

More Info

Acute sepsis following a cervical biopsy is a serious and rare complication that can arise, particularly in patients who may already have underlying health issues or compromised immune systems. In your case, the patient experienced a rapid decline in health following the biopsy, leading to a diagnosis of acute sepsis. This situation raises several important questions regarding diagnosis, treatment, and management.

1. Finding the Infection Source: In cases of acute sepsis, identifying the source of infection is crucial for effective treatment. While urine cultures have identified bacteria, further diagnostic methods may be necessary to pinpoint the infection's origin. Advanced imaging techniques such as CT scans or MRIs can help visualize internal structures and identify abscesses or other sources of infection. Blood cultures should also be performed to identify any pathogens present in the bloodstream. If the standard tests are inconclusive, more specialized tests, such as PCR (Polymerase Chain Reaction) assays, can be employed to detect specific bacterial DNA. Discussing these options with the attending physician is essential, as they can guide you on the best course of action based on the patient's condition.

2. Antibiotic Treatment Duration: The duration of antibiotic therapy in sepsis cases can vary significantly based on the patient's clinical response and the identified pathogens. While a common practice is to start with a 7-day course of broad-spectrum antibiotics, this can be adjusted based on the patient's progress and culture results. If the infection source remains unidentified after 7 days, the medical team may consider extending the antibiotic therapy or switching to a different antibiotic based on clinical judgment and the patient's response. Continuous monitoring of the patient's vital signs, laboratory results, and overall clinical status is critical in making these decisions.

3. Cervical Biopsy and Sepsis Cases: While it is uncommon for a cervical biopsy to lead to acute sepsis, it is not impossible. Factors such as the patient's age, underlying health conditions, and the nature of the biopsy procedure can contribute to this risk. For instance, if the biopsy was performed on a patient with a weakened immune system or existing infections, the likelihood of complications increases. Additionally, if sterile techniques were not adequately followed during the procedure, this could also lead to infection. Documented cases of sepsis following cervical biopsies exist, but they are rare and often involve patients with predisposing factors.

In summary, acute sepsis following a cervical biopsy is a complex situation that requires careful management and a thorough investigation to identify the infection source. Collaboration with the healthcare team is essential to ensure that the patient receives appropriate care and that any necessary diagnostic tests are performed promptly. It is also important to maintain open communication with the medical team regarding treatment options, potential complications, and the patient's overall prognosis.

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