Sepsis after gynecological procedure
October 30, 2010 | 20,00 EUR | answered by Dr. med. Ralf Berg
I have a gynecological procedure scheduled for Tuesday, involving a laparoscopy of the abdomen and uterus, with a check on the patency of the fallopian tubes. I'm not worried about that. What worries me is the potential for sepsis, which can occur after such a procedure. I recently had a vaginal yeast infection and I'm afraid that the candida bacteria may still be present somewhere in the vagina. The yeast infection came out of nowhere... I didn't take any antibiotics, didn't have excessive hygiene, etc. Possible causes could be stress or a weak immune system. I've heard that some women always have candida bacteria in their vagina. Is that enough to cause sepsis after such a procedure? What do surgeons do to prevent sepsis during surgery? How can sepsis be detected before symptoms appear? Is there a test for it? How quickly do the symptoms appear? I need the answer by 11/01/2010, as I have the operation scheduled for 11/02/2010 and I want to be prepared in case something happens and quick action is needed. Thank you.
Dear inquirer,
Sepsis is a (usually) bacterial infection in the body that has gotten out of control, where the immune system has failed. This is a serious condition that can also lead to death, so every surgical procedure, including yours, must be informed about this risk. A massive fungal infection can also cause a fungal sepsis.
As you already know, it is normal for many fungi to LIVE ON (not in or under) our skin or sometimes even in the vagina without causing harm. Such colonization, even if it occurs in the vagina, is NOT enough to cause sepsis. Also, you do not need to worry about bacteria or fungi entering your abdominal cavity during the planned examination of tubal patency. The dye used is not injected through the vagina, but applied directly through the cervix into the uterus. The area behind the cervix is normally sterile in healthy individuals. Therefore, it does not matter how the germ and fungal colonization in your vagina currently is. If surgeons were to see signs of an acute infection in the vagina during the gynecological examination, the procedure would be postponed. Furthermore, as with all surgical procedures, the highest level of cleanliness and sterility is ensured. Not only are all instruments, gloves, and surgical drapes sterile, but the skin is also disinfected as much as possible to kill or at least weaken the germs present.
Please do not worry. Infection rates in hospitals are published and monitored. It is true that depending on the procedure, there may be between 1-5% of wound infections. Severe sepsis affecting the entire body is very rare. People who develop such a condition either have a weakened immune system (AIDS), have other organ damage (heart, lungs), are severely injured, or are very elderly. These are things that I assume do not apply to you.
As a preventive measure against sepsis, antibiotics are administered intravenously during the surgery if there is a risk (e.g. from a ruptured appendix) according to the surgeon's judgment. Symptoms of sepsis after surgery can include very high fever, chills, redness of the entire body, and a very poor general condition. These are things you may have experienced with a severe flu, influenza, or pneumonia. The doctor also has the ability to detect sepsis through laboratory tests and blood cultures. These are routine measures in all hospitals that are always carried out for your protection. There is no "sepsis test" or specific preventive measures. If you experience diarrhea or an infection before the surgery, you should inform the surgeon or anesthetist so that the appointment can be rescheduled.
From what I can assess from here, you don't need to do anything, so there is no need to fear a fungal sepsis. I hope I was able to answer your questions and wish you all the best for the procedure.
Dr. R. Berg
