Post–Loop Electrosurgical Excision Procedure Sepsis in a Human Immunodeficiency Virus–Infected Woman

Abstract

Squamous intraepithelial lesions are more prevalent in women infected with the human immunodeficiency virus (HIV) compared with immunocompetent women. Loop electrosurgical excision procedure (LEEP) is commonly used to treat squamous intraepithelial lesions because it may be performed as an outpatient procedure with minimal blood loss and a low complication rate. We report a major infectious post-LEEP complication in an HIV-infected female who had an uneventful LEEP in which a cellulose hemostatic agent was used. Despite the severity of the infection, she was successfully treated with a minor surgical procedure along with broad antibiotic coverage. Although a cellulose hemostatic agent contaminated with perineal secretions may have served as a nidus for infection, use of perioperative antibiotics or cervical cleansing should be considered to prevent sepsis in immunocompromised hosts.