Abstract
IntroductionPost-partum, post-sterilization tubo-ovarian abscess is a rare event. Fusobacterium necrophorum subspecies funduliforme, a normal flora found mainly in the oral cavity, appears to be the etiologic organism.Case presentationIn this case report, a 25-year-old Thai woman had a post-partum, post-sterilization tubo-ovarian abscess caused by the strictly anaerobic bacterium, Fusobacterium necrophorum subspecies funduliforme. Progressively severe symptoms started 3 weeks after her third vaginal delivery with a tubal sterilization on the following day. On admission, she presented with peritonitis and impending shock. An exploratory laparotomy showed a ruptured left tubo-ovarian abscess. A segment of her ileum had to be resected because of severe inflammation.ConclusionsFusobacterium necrophorum subspecies funduliforme can be an etiologic organism of a ruptured tubo-ovarian abscess following tubal sterilization in a healthy host.
Highlights
Post-partum, post-sterilization tubo-ovarian abscess is a rare event
Fusobacterium necrophorum subspecies funduliforme can be an etiologic organism of a ruptured tubo-ovarian abscess following tubal sterilization in a healthy host
The post-partum period appears to be the least likely time to develop a Tubo-ovarian abscess (TOA) because ascending infection, which is the major pathophysiology in developing pelvic inflammatory disease (PID) in most women, rarely occurs during this phase
Summary
Tubo-ovarian abscess (TOA), characterized by an inflammatory complex mass in the pelvis, accounts for 15% of all pelvic inflammatory diseases (PIDs) [1]. In women who have had tubal sterilization (TS), the incidence of TOA is minimal because the procedure blocks communication between the genital tract and the pelvic cavity [3] This blockage should prevent an ascending transmission of any organisms, if present, from the genital tract proximal to the site of TS into the peritoneal cavity. Case presentation A 25-year-old Thai woman (gravida 3, para 3) had her third uneventful vaginal delivery followed by TS by modified Pomeroy technique on the following day She experienced a persistent low-grade fever and abdominal pain that began in the third post-partum week and deteriorated over time. She was clinically well during all of her follow-up visits
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