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Abstract: Women with abnormal leucorrhea, most often caused by vaginitis, should be treated with medication as early as possible, otherwise vaginal pathogenic bacteria can easily cause acute endometritis. In this case, the leucorrhea was initially increased, yellowish and odorous, and was not treated. 4 days later, menstruation came and dysmenorrhea occurred, and the pain was persistently aggravated. After consultation, the diagnosis of acute endometritis was confirmed after examination, and the condition improved quickly through antibiotic treatment, rehydration therapy and physical cooling, and the symptoms of fever and abdominal pain gradually subsided until they disappeared.
Basic information】Female, 30 years old
Type of disease】Acute endometritis
Hospital】Guangxi Zhuang Autonomous Region Jiangbin Hospital
Date of consultation】April 2022
Treatment plan】Antibiotic therapy (ceftriaxone sodium + metronidazole) + rehydration therapy (sodium lactate Ringer injection, glucose sodium chloride injection, etc.) + physical cooling (ice bag external application)
[Treatment period] 7 days in hospital, 1 week after the outpatient review
Treatment effect】The condition is controlled, and the fever and abdominal pain are relieved until they disappear.
I. Initial consultation
The patient reported an increase in leucorrhea, yellowing and odor on April 7, which was not treated. 4 days later, her menstrual flow was slightly higher than usual, accompanied by blood clots, and she had no menstrual pain in the past. Outpatient blood test showed 18.79×10^9/L leukocytes and 96.5% neutrophil percentage, both of which were significantly elevated. After sterilization, a gynecological examination was performed, which showed significant painful cervical elevation and uterine pressure pain.
II. Treatment history
After admission, we explained to the patient that when the leucorrhea increased, yellowish and smelly, it indicated the presence of vaginitis, which needed to be treated promptly, otherwise the body’s resistance and immunity decreased during menstruation, which could lead to the proliferation of pathogenic bacteria and upward movement to the uterine cavity triggering acute endometritis, resulting in symptoms of infection such as lower abdominal pain, chills and fever, and in serious cases, pelvic inflammatory disease, chronic pelvic pain and infertility. The patient was informed and agreed to actively cooperate with the treatment. The patient was given intravenous infusion of antibiotics (ceftriaxone sodium + metronidazole) and rehydration therapy (sodium lactate Ringer injection, sodium chloride glucose injection, etc.), as well as external application of ice bags for physical cooling.
III. Treatment effect
After 3 days of combined drug and physical therapy, the patient’s body temperature returned to normal, abdominal pressure pain and rebound pain were reduced, and the routine blood count was 15.45×10^9/L and 86.1% of neutrophils, both of which indicated a decrease, indicating that the treatment was effective, and intravenous antibiotic infusion therapy was continued. After 7 days of treatment, the routine blood count was 12.75×10^9/L and the neutrophil percentage was 83.2%, and the painful cervical lifting and uterine pressure on gynecological examination were significantly reduced.
IV. Notes
We are glad that the patient’s condition has effectively improved after active drug treatment, but we suggest that the patient still needs to pay attention to the following matters after discharge.
1, must follow up as prescribed by the doctor, according to the course of standardized application of antibiotics, otherwise the treatment is not complete, acute endometritis is prone to prolonged development into chronic inflammation, as well as the possible secondary to more gynecological diseases.
2. pay attention to strengthening nutrition, it is recommended to give light and nutritious food, especially during fever treatment, high-calorie, high-protein, high-vitamin liquid or semi-liquid food, and drink more water.
3, it is recommended to relax, ensure sleep, combine work and rest, regular life, appropriate exercise is recommended during the recovery period.
4.Avoid sexual life during the treatment period, otherwise it is easy to aggravate the infection, which is not conducive to treatment.
V. Personal insight
When women have vaginitis, endometritis and other gynecological inflammatory diseases, the initial symptoms are mild, and if they do not pay attention to them and consider seeking medical attention only after their condition has worsened, it not only makes treatment more difficult, but also prolongs the treatment cycle. In fact, gynecological inflammatory diseases are easy to treat in the early stages, but if the inflammation worsens, a series of complications can easily occur, leading to difficulties in treatment and a relatively long course of treatment, and incomplete treatment can easily be extended into chronic diseases or recurrent attacks, so it is recommended that women find gynecological inflammatory diseases should be dealt with as early as possible.