Abscess In Woman Research Articles

Is Chronic Pelvic Inflammatory Disease an Exclusively Medical Gynecological Disease, or It May Be a Surgical Challenge?

Pelvic inflammatory disease is an infectious condition affecting women’s upper genital tract, including the uterus, fallopian tubes, and ovaries. It primarily arises from an infection that spreads upward from the lower genital area. The relationship between chronic pelvic pain and coexisting conditions is a key focus in its diagnosis and treatment. This type of pain is also considered a form of reflex dystrophy, involving both neurological and psychological components, the first line treatment consists in antibiotherapy. For patients with complex or severe pelvic abscesses, surgical intervention may be considered in selected cases. The primary surgical techniques employed are open and laparoscopic surgery, both aimed for abscess removal. MRI or Doppler ultrasonography may be employed when there is a suspicion of adnexal torsion, adenomyosis or deep pelvic endometriosis, especially if the ultrasound results are unclear or inconclusive Laparoscopic surgery has increasingly become favored by both healthcare professionals and patients. Moreover, laparoscopy has emerged as the most valuable tool for diagnosing chronic pelvic pain. The approach to treating pelvic abscesses in women of reproductive age depends greatly on clinical assessments, individual patient factors, and the desire to preserve fertility. However, laparoscopy may present technical difficulties in patients with severe pelvic abscesses, particularly those with extensive adhesions or a closed-off pelvic area, requiring advanced surgical expertise. Women with associated conditions such as endometriosis often experience a more severe form of pelvic inflammatory disease, which is less responsive to antibiotics and more frequently requires surgical resolution. The surgical treatment should be performed individualized to the clinical condition of the patient and the time of intervention must be carefully chosen.

Profile of Antimicrobial Resistance and Sensitivity in Vulvar Abscesses in Women Attending a Tertiary Hospital

Context: Vulvar abscess is a highly prevalent pathology in patients seeking emergency care; however, its epidemiology has yet to be fully clarified. Aims: This study aimed to determine possible risk factors, the most common microorganisms involved and the appropriate antibiotic therapy in cases of vulvar abscesses treated in a tertiary hospital. Settings and Design: This prospective study included 51 women who presented with a vulvar abscess and sought medical help at the hospital’s gynaecological emergency room over a 70-week period. Methods: Drainage of the abscess and microbiological analysis allowed the pathogen responsible for the lesion to be identified, as well as the profile of antimicrobial sensitivity and resistance to be determined. Statistical analysis: Frequencies and percentages, as well as means, medians and standard deviations, were calculated. Associations between the study variables were determined using the chi-square test or Fisher’s exact test. Results: Overall, 52.94% of the cultures were positive for methicillin-resistant Staphylococcus aureus (MRSA). There was no significant difference in age between the patients infected with MRSA and those infected with other agents (p>0.05). The MRSA isolates were sensitive to sulfamethoxazole + trimethoprim and to gentamicin, as were the great majority of the other pathogens. Shaving the vulvar region was the most important risk factor, being present in 74.5% of cases. Conclusion: MRSA is highly prevalent and a major cause of vulvar abscesses. Therefore, in these cases, an antibiotic therapy regimen with coverage for MRSA, such as sulfamethoxazole-trimethoprim, should be initiated as soon as possible.

Recurrent Bartholin's Cyst: Literature Review and Case Report

Bartholin's cyst is a form of cystic (fluid-filled) tumor on the vulva. Bartholin's cyst is a cyst that forms due to blockage of the Bartholin's gland duct, which causes retention and cystic dilatation. Reports indicate that a 45-year-old woman came to the Obstetrics and Gynecology Polyclinic at Pertamina Bintang Amin Hospital, Malahayati Bandar Lampung, experiencing a recurrence of a left Bartholini abscess for the third time after two external incisions. The treatment carried out in this patient was given antibiotics and analgesics and it was recommended to do surgery with an extirpation procedure. Recurrent Bartholin's gland abscesses in women of reproductive age are generally associated with a risk of contact with sexually transmitted infection polymicrobials. Needle aspiration and incision and drainage are the two simplest procedures, not recommended because of the relatively increased recurrence rate.

Risk factors for the development of tubo-ovarian abscesses in women with ovarian endometriosis: a retrospective matched case\u2013control study

BackgroundThe purpose of this study was to assess the risk factors associated with the development of tubo-ovarian abscesses in women with ovarian endometriosis cysts.MethodsThis retrospective single-center study included 176 women: 44 with tubo-ovarian abscesses associated with ovarian endometriosis and 132 age-matched (1:3) patients with ovarian endometriosis but without tubo-ovarian abscesses. Diagnoses were made via surgical exploration and pathological examination. The potential risk factors of tubo-ovarian abscesses associated with ovarian endometriosis were evaluated using univariate analysis. The results (p ≤ 0.05) of these parameters were analyzed using a multivariate model.ResultsFive factors were included in the multivariate conditional logistic regression model, including in vitro fertilization, presence of an intrauterine device, lower genital tract infection, spontaneous rupture of ovarian endometriosis cysts, and diabetes mellitus. The presence of a lower genital tract infection (odds ratio 5.462, 95% CI 1.772–16.839) and spontaneous rupture of ovarian endometriosis cysts (odds ratio 2.572, 95% CI 1.071–6.174) were found to be statistically significant risk factors for tubo-ovarian abscesses associated with ovarian endometriosis.ConclusionsAmong the factors investigated, genital tract infections and spontaneous rupture of ovarian endometriosis cysts were found to be involved in the occurrence of tubo-ovarian abscesses associated with ovarian endometriosis. Our findings indicate that tubo-ovarian abscesses associated with ovarian endometriosis may not be linked to in vitro fertilization as previously thought.

Manejo médico de apostemas mamarios durante el siglo xviii en el Nuevo Reino de Granada

IntroductionThe University of La Sabana preserves a collection of medical prescriptions used in the eighteenth century in New Granada; one of these contains phytotherapeutic agents to alleviate the symptoms caused by mammary gland infections. ObjectiveTo present a formula used to treat breast abscesses and to determine whether the components are effective in resolving this entity. Materials and methodsWe conducted a search in the Historical Archive of the Octavio Arizmendi Posada Library of the University of La Sabana, where we found the formula “abscess in women's breasts”. We also collected data and performed a literature search on this method in the PubMed, Google Scholar and SciELO databases. ResultsThe use of plants such as Luffa cylindrica and Lonicera japonica could prevent the development of breast abscesses due to their galactagogue, analgesic and anti-inflammatory properties. Cabbage leaf also plays an important role in relieving pain in persons with abscesses, due to its analgesic properties. ConclusionThrough the review of eighteenth century texts, we found a colonial medical prescription and reviewed the phytotherapeutic effects of its components, highlighting its galactagogue benefits. This allows a comparison between current medical evidence and some of the natural methods used for breast abscesses in New Granada during the eighteenth and nineteenth centuries.

Dental adaptations of Bronze Age Harappans: Occlusal wear, crown size, and dental pathology

Systematic study of dental attributes yields insights regarding diet and subsistence that cannot be gained from the archaeological record alone. This analysis documents occlusal tooth wear, tooth crown dimensions and dental pathology of an expanded dental sample from Harappa (2550–2030cal BC; Pakistan). New floral and faunal evidence of subsistence indicates a mix of agriculture and pastoralism that can be integrated with evidence of dental attributes and disease to reveal the impact of Harappan diet on oral health.An enlarged dental sample (58 specimens, 910 teeth) from mature phase Harappa was analyzed using Scott’s quadrant wear system, measures of crown size, and prevalence of seven pathological dental lesions. All data were collected by the author using standard methods. Sex differences were found in wear, tooth size and prevalence of dental diseases. Females exhibit greater caries prevalence and antemortem tooth loss than men, an attribute associated with higher rates of pulp exposure and abscesses in women. At Harappa antemortem tooth loss results from penetrating caries, while in foragers the cause is severe occlusal wear. In contrast to early Holocene foragers of north India (Damdama, 8800–8600 BP), Harappans have greater occlusal wear, smaller teeth, and a distinct dental pathology profile.

Clinical analysis of pelvic abscess with endometriosis

Objective: To investigate the clinical features, diagnosis and treatments of pelvic abscess with endometriosis. Methods: A retrospective analysis was performed on 129 cases of pelvic abscess in Peking Union Medical College Hospital from January 2000 to January 2016. Among them, 34 women with endometriosis were divided into the study group and the others were in the control group. The clinical characteristics, therapeutic regimens and outcomes were compared. Results: (1) General conditions: there were no statistic differences between the two groups in age, WBC, serum CA(125), intrauterine device in use, pelvic inflammatory disease history; while incidence rates of dysmenorrhea (65%, 22/34) and infertility (21%, 7/34) in the study group were higher than those in the control group (all P<0.05). (2) Clinical manifestations: fever, abdominal pain and pelvic mass were the main symptoms in two groups. The incidence rates of septic shock were 12% (4/34) in the study group and 2% (2/95) in the control group (P<0.05). (3) Treatment: treatment with puncture all failed in the study group (7/7) and surgeries were required. In contrast, there was only 1/19 treatment failure with puncture in the control group. The puncture failure rates were statistically significant (P<0.05). Compared with the study group and the control group, there were significant differences (P<0.05) in the operation time of laparoscopic surgery [(76±41) versus (53±21) minutes] and of laparotomy [(168±58) versus (116±35) minutes], intra-operative blood loss of laparoscopic surgery [(216±296) versus (43±36) ml] and of laparotomy [(448±431) versus (145±24) ml]. Conclusions: Pelvic abscess in women with endometriosis is more severe and refractory to antibiotics and puncture treatment. Active surgical intervention is required. Although surgical procedures are often difficult, prognosis is comparatively satisfied.

CT differentiation between tubo-ovarian and appendiceal origin of right lower quadrant abscess: CT, clinical, and laboratory correlation.

To investigate which clinical, laboratory, and CT findings potentially facilitate the differential diagnosis between tubo-ovarian abscess (TOA) and periappendicular abscess (PAA), we retrospectively reviewed abdominal CT examinations and medical records for all women who presented to our medical center with unilateral right pelvic abscess formation who underwent CT evaluation from 2004-2014. A wide spectrum of clinical data and imaging findings were recorded. CT diagnoses were made in consensus by two experienced body radiologists blinded to the final diagnosis. Findings associated with the infections were compared using the chi-square (χ(2)) or the Fisher exact test. Ninety-one patients were included; 58 with PAA (mean age 46 years) and 33 with TOA (mean age 37 years). Pain on cervical motion (67 %) and vaginal discharge (21 %) were significantly more common in TOA; other clinical signs were similar. The presence of right ovarian vein entering the mass on CT had 100 % specificity and 94 % sensitivity to TOA. Distended right fallopian tube (79 %), mass posterior to mesovarium (76 %), contralateral pelvic fat stranding (55 %), and thickening of sacrouterine ligaments (55 %) were significantly more common in TOA. Positive "arrowhead sign" (91 %), mesenteric lymphadenopathy (85 %), small bowel wall thickening (55 %), fluid in the right paracolic gutter (50 %), and cecal wall thickening (48 %) were significantly more common in PAA;internal gas was revealed only in PAA (33 %). Distinct CT features can increase diagnostic certainty regarding the origin of right lower quadrant abscess in women.

Differential diagnosis of pelvic cystic lesions caused by hemorrhage from inflammatory abscess using CT attenuation in women with acute abdomen.

To determine the efficacy of computed tomography (CT) attenuation of cystic lesions measured on an image browsing system to distinguish abscess from hematoma in women with acute abdomen. The medical records of female patients of reproductive age with acute abdomen who were treated over a 7-year period in a single center and who had undergone laparotomy or laparoscopic surgery and preoperative pelvic CT scanning were retrospectively analyzed to identify those with hematoma or abscess cyst formation. Nineteen patients with tubo-ovarian abscess (abscess group) and six patients with hematoma (hematoma group) formation in the pelvis were included in the analysis. The preoperative CT images of the tubo-ovarian cyst were retrospectively investigated on the basis of cyst attenuation. CT attenuation of the cyst measured by both two gynecologists could be used to clearly distinguish inflammatory disease with abscess formation from bleeding disease with hematoma. CT attenuation on a picture archiving and communication system can distinguish hematoma from abscess in women with acute abdomen. This may significantly contribute to making differential diagnosis without interpretation by a medical radiologist.

Association Between Gelatin-Thrombin Matrix Use and Abscesses in Women Undergoing Pelvic Surgery

Association Between Gelatin-Thrombin Matrix Use and Abscesses in Women Undergoing Pelvic Surgery

Association between gelatin-thrombin matrix use and abscesses in women undergoing pelvic surgery.

To assess the association between the use of gelatin-thrombin matrix and the development of pelvic abscess during hysterectomy as well as factors associated with surgeons' use of this product. Data for patients undergoing hysterectomy for obstetric-gynecologic pathology were abstracted from databases at a tertiary hospital between 2009 and 2012. Open and minimally invasive hysterectomies were included and vaginal hysterectomies were excluded. Blood loss, surgery type, comorbidities, abscess formation, and use of gelatin-thrombin matrix were examined. Abscess was defined as a walled-off fluid collection (documented with computed tomography scan) with fever (greater than 38°C) or leukocytosis (greater than 11,000/microliter). Standard statistical models were used. Of the 413 patients identified, 213 (51%) underwent surgery for malignancy. Gelatin-thrombin matrix was used in 166 patients (40%). The overall rate of abscess was low (3%). In bivariate analyses, blood loss greater than 500 mL (odds ratio [OR] 3.9, 95% confidence interval [CI] 1.1-12.9, P=.021], ascites (OR 6.5, 95% CI 1.6-26.1, P=.023), drain placement (OR 4.5, 95% CI 1.3-15.1, P=.009), and gelatin-thrombin matrix use (OR 7.0, 95% CI 1.5-32.9, P=.009) were significantly associated with abscess formation. Multivariate logistic regression revealed that only gelatin-thrombin matrix use predicted the development of pelvic abscess (OR 7.0, 95% CI 1.5-32.9, P=.013). We found that gelatin-thrombin matrix use was associated with an increased risk of pelvic abscess. Although these products are important in the setting of bleeding, these data suggest that the liberal use of sealants is not without risk. III.

An outbreak of post-partum breast abscesses in Mumbai, India caused by ST22-MRSA-IV: genetic characteristics and epidemiological implications

A cluster of methicillin-resistant Staphylococcus aureus (MRSA) breast abscesses in women who had given birth at a hospital in Mumbai, India was investigated retrospectively. Nineteen of 20 cases were caused by a single clone: pvl-positive, spa type 648 (Ridom t852), ccrB:dru subtype 3:0, ST22-MRSA-IV. Despite the presence of pvl and SCCmec type IV, which are common genetic markers in community-associated MRSA, this outbreak was caused by a healthcare-associated, community-onset MRSA that was common in the hospital environment. Thus, infection control practices may have an important role in limiting the spread of this virulent clone.

Breast Abscess, an Early Indicator for Diabetes Mellitus in Non‐lactating Women: A Retrospective Study from Rural India

Breast abscess is commonly seen in lactating and non-lactating women. Diabetes mellitus (DM) frequently predisposes to soft tissue infections and has many different presentations. But DM presenting in the form of breast abscess is yet to be studied, and we believe our study is the first to explore this connection. We collected 30 cases of breast abscess in women who presented to our hospital from May 2010 to June 2011 retrospectively. They were classified into lactating and non-lactating women, and their glycemic status was evaluated, together with length of hospital stay, management, recurrence, and follow-up status after 6 months. We found that of the 30 patients in our study, 20% had high blood sugar levels. And 37.5% of the non-lactating women were diagnosed newly with DM. This study shows that DM can present as breast abscess in non-lactating women. Therefore, non-lactating women with a breast abscess should be evaluated for DM.

Tubo-ovarian abscess in woman with an intrauterine device forgotten for 22 years

We report on a case of pelvic inflammatory disease in a 53 year old woman using an intrauterine contraceptive device (IUD) for a time period of 22 years. Clinical symptoms were fever up to 38°C and severe abdominal pain. Endoscopic findings were a tubo-ovarian abscess of the complete pelvis and a forgotten IUD with a smear positive for Escherichia coli and Candida albicans. The patient was treated with a surgical therapy and by antibiotic combination. Diagnosis was performed by histopathological examination.

ASSOCIATION OF HIV WITH BREAST ABSCESS AND ALTERED MICROBIAL SUSCEPTIBILITY PATTERNS.

BACKGROUND: Breast abscesses account for 15% of surgical day cases seen in the UTH. Nearly all of these cases occur in lactating women. Pre-natal HIV prevalence among women seeking care at UTH was estimated at 25% as of 2004. Baseline surveys have shown that up to 60% of soft tissue infections presenting to the UTH are HIV related. OBJECTIVES: To determine if HIV infection is a risk factor for the development of breast abscesses in women presenting to the University Teaching Hospital (UTH) in Lusaka, Zambia. Secondary objective was to identify bacteriological aetiologies and drug sensitivity patterns associated with breast abscesses at UTH. STUDY DESIGN: A case-control study of 110 consecutive breast-feeding mothers diagnosed with breast abscess upon presentation to the UTH surgical service (cases) and 110 representative controls recruited from the UTH postnatal clinic. MAIN OUTCOMES: HIV seropositivity and CD4 counts (if HIV positive) among cases and controls. RESULTS: Fifty-four out of 110 (49.1%) lactating women with breast abscess had positive serologic tests for HIV. Only 25 of 110 (23%) control women tested HIV positive. This difference was statistically significant, with an odds ratio of 3.28 (95% CI 1.83 - 5.87; p = 0.001). Mean CD4 counts in cases were lower than in controls (338 vs. 568, p<0.001). Staphyloccocus aureus was the main causative agent (91.8%) of isolates. Among S. aureus isolates, 70 of 101 (69.3%) were oxacillin susceptible. Forty-three of 50 (86.0%) specimens from HIV positive patients were resistant to SMX-TMP compared with only 61% of specimens from HIV negative patients (p=0.004). CONCLUSIONS: HIV infection appears to be a significant risk factor in the development of breast abscess in lactating women in Zambia. Staphylococcus aureus remains the main causative agent, with MRSA accounting for 30.7% of isolates. SMX-TPM resistance likely stems from the wide spread use of the drug for PCP prophylaxis in HIV positive patients. It therefore should not be used for treatment of acute bacterial infections. HIV related breast infections could be considered as a possible entry point to HIV treatment now that the CD4 treatment guidelines have been adjusted to 350cells/cmm, although this requires further studies for validation.

Endometrioma and oocyte retrieval-induced pelvic abscess: a clinical concern or an exceptional complication?

Even if in vitro fertilization (IVF) is currently considered an effective treatment in women with endometriosis, several therapeutic aspects remain to be clarified. In particular, a debated and still unsolved topic in this context is whether or not endometriomas should be treated prior to initiate an IVF cycle. There is currently cumulative evidence supporting the view that surgical treatment does not improve ovarian responsiveness to gonadotropins. On the other hand, a possible concern in this field is the risk of causing the infection of the endometrioma following oocyte retrieval. In this regard, it is noteworthy that the bloody content of the cyst may serve as an excellent culture medium and may facilitate the spread of infection. Not surprisingly, the development of pelvic abscess following oocyte retrieval has been repeatedly reported. However, the precise frequency of this complication is currently unknown. Establishing the entity of this complication is of utmost interest. The knowledge that the presence of an endometrioma may favor the development of a pelvic abscess following oocyte retrieval in a consistent proportion of women would prompt the need to consider the removal of the cyst prior to initiate the cycle. To clarify this point, we set up a follow-up study aimed to estimate the frequency of pelvic abscess in women with endometrioma who have undergone IVF. Case series. Patients with ovarian endometriomas who underwent oocyte retrieval between January 2004 and December 2006 were considered for study entry. According to the policy of our Institution, surgical excision of these cysts prior to initiate the cycle is not recommended. Clinical data were extracted from patients' chart and selected women were contacted by phone for follow-up. One hundred-nineteen patients satisfied our selection criteria. They underwent 214 retrieval cycles. None of the recruited women complained a pelvic abscess. The frequency (95% CI) of this complication was thus 0.0% (0.0–1.7%). In women with endometriomas who are selected for IVF, the risk of developing pelvic abscess following oocyte retrieval is very low. Fear about this complication should not play a role in the decision-making process regarding the opportunity to remove the cyst prior to initiate the cycle.

Association of CD14, IL1B, IL6, IL10 and TNFA functional gene polymorphisms with symptomatic dental abscesses

To investigate in individuals with symptomatic dental abscesses the occurrence of functional polymorphisms within five genes involved with the immune response. The functional gene polymorphisms analysed were CD14 (-260 C/T), IL1B (+3954 C/T), IL6 (-174 G/C,), IL10 (-1082 G/A) and TNFA (-308 G/A). Genomic DNA obtained from oral swabs from individuals with symptomatic dental abscesses and asymptomatic inflammatory periapical lesions, without previous exacerbation, was submitted to restriction fragment length polymorphism (RFLP) analyses to determine each individual genotype. The chi-square and principal components analysis tests were used for statistical analysis. A significant association was observed between the occurrence of the GG genotype or the G allele expression of the polymorphic locus-174 (G/C) of the IL6 gene, and the presence of the symptomatic dental abscesses in women and in individuals < or =35 years old. The principal components analysis suggested predominance of the symptomatic dental abscesses in individuals displaying: high-producer IL6 genotype; intermediate and high-producer IL1B genotypes and low-producer TNFA genotype. The present study suggests that genetic factors are associated with susceptibility to develop symptomatic dental abscesses.

Increased occurrence of tubo-ovarian abscesses in women with stage III and IV endometriosis

Women who had stage III–IV endometriosis and who were nulliparous or who had delivered no more than two children were much more likely to develop tubo-ovarian abscesses than those without endometriosis.

Genital bacteroidal abscesses in women

Genital bacteroidal abscesses in women

Goung and Mc Crea. Urethrocele, urethral diverticulum, suburethral abscess in women. (Urol. And cut. Rev. No. 2, 1937)

By the terms indicated in the title of the article, the authors mean the presence of a sac in the lower wall of the urethra in women, located between the walls of the urethra and the vagina.