日本性感染症学会誌 Journal of Japanese Society for Sexually Transmitted Infections

We report a rare case of a postoperative infection following cesarean delivery, which was caused by coinfection with Prevotella bivia and Ureaplasma parvum. On postoperative day 6, the patient was diagnosed with endometritis and initiated on antibiotic treatment; however, the fever persisted. She subsequently developed ascites and a subcutaneous abscess, necessitating reoperation. P. bivia was isolated from the subcutaneous abscess, but the antimicrobial treatment was only partially effective, and ascites reaccumulated. Clinical improvement was achieved following the addition of levofloxacin and peritoneal drainage. Ultimately, U. parvum was also detected in both the subcutaneous abscess and ascitic fluid, indicating its contribution to the postoperative infection. This case highlights that U. parvum may potentiate pathogenicity when coinfecting with other bacteria. In post-cesarean infections refractory to standard treatment, it is important to consider the potential involvement of Ureaplasma species.