Post-Abdominal Myomectomy Infection: Warning Signs & Emergency Action

Infection after abdominal myomectomy is a serious complication requiring immediate recognition and treatment.

Warning Signs (Any = Urgent Evaluation)

• Fever: >38°C (100.4°F) — most common sign
• Chills/rigors
• Abdominal pain: Increasing, not improving with prescribed analgesics
• Wound issues: Spreading erythema, warmth, induration, purulent drainage, dehiscence
• Vaginal bleeding: Heavy (>pad/hr) or foul-smelling
• GI/GU: Nausea/vomiting, ileus, dysuria, retention
• Systemic: Tachycardia, hypotension, confusion, lethargy (sepsis signs)

Timeframe

• Most surgical site infections: Post-op days 3–14
• Deep/organ space: Up to 30 days
• Late: Mesh infection (if used) — months to years

Common Pathogens

• Skin flora: S. aureus, coagulase-negative staph
• Enteric: E. coli, Enterococcus, Bacteroides
• Vaginal: Group B Strep, anaerobes

Immediate Actions

1. Contact surgeon ON CALL immediately
2. Go to ER if: fever >38.5°C, hemodynamic instability, altered mental status
3. Expect: CBC, blood cultures, wound culture, CT abdomen/pelvis, IV antibiotics
4. Possible: Wound exploration, drainage, reoperation

Do not wait. Early intervention prevents sepsis, adhesions, infertility compromise.