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May 13, 2013

Womb to Grow

Author Affiliations

Author Affiliation: Ms Mu is a medical student at Johns Hopkins University School of Medicine, Baltimore, Maryland.

JAMA Intern Med. 2013;173(9):729. doi:10.1001/jamainternmed.2013.313

I first met Emily during my third year of medical school, and she deeply impressed upon me that in matters of the womb, patient wishes define when less is more. Emily was a 33-year-old woman (gravida 0, para 0) admitted for fever and right flank pain lasting several weeks. Emily's diagnosis was initially elusive. She had received a full course of antibiotics to treat suspected pyelonephritis. However, when her pain, leukocytosis, and fever persisted, we searched for another source of infection. A transvaginal ultrasound examination ultimately revealed extensive endometriosis and 2 large cystic masses in the right ovary that were the likely source of her infection.