Background: Pyometra is defined as an accumulation of purulent material
in the uterine cavity. It is caused by natural drainage impairment within the
cervix and occurs predominantly in elderly women. In this study, we aimed to
investigate the clinical characteristics and recurrent risk of pyometra.
Methods: Data for patients diagnosed with pyometra between 2010 and 2021
were retrospectively reviewed. Basic patient characteristics, including age,
underlying disease, management, chief complaint, antibiotics, and isolated
organisms, were investigated. The risk of recurrence of pyometra was assessed
using multivariate logistic regression analyses. In total, 65 patients with
pyometra were included in this study. Results: The mean age of the
patients was 75.8 16.4 years. About half of the patients had been
admitted to a nursing hospital due to poor mobility, and 61.5% of the patients
had an Eastern Cooperative Oncology Group performance score of 2 or higher. The
most prevalent presenting symptoms were vaginal discharge (73.9%) and fever
(16.9%). Forty-eight (75.0%) patients underwent drainage, and seven (10.9%)
underwent hysterectomy. Escherichia coli accounted for the most cases (36.9%),
followed by Klebsiella pneumoniae (20.0%). Overall, 17 patients were
extended-spectrum -lactamase positive. Recurrence after drainage
occurred in 16 (24.6%) of the 65 patients, and two patients died from septic
shock. The isolation of Klebsiella pneumoniae was identified as a
significant risk factor for recurrence (odds ratio (OR): 4.71; 95% confidence
interval (CI): 1.09–20.47; p 0.05). Conclusions: Because
pyometra often occurs in elderly patients with chronic diseases, it is important
to pursue appropriate treatment and prevention of recurrence to decrease the
morbidity and mortality associated with this condition. The isolated organisms
should be considered as a predisposing factor for recurrent pyometra.