Bartholin's Abscess Research Articles

Randomized Pilot Study Comparing a Rubber Ring Catheter to the Word Catheter in the Treatment of Bartholin Abscesses

Randomized Pilot Study Comparing a Rubber Ring Catheter to the Word Catheter in the Treatment of Bartholin Abscesses

Childhood Benign Surgical Gynaecological Disorders in Ilorin, Nigeria.

Context: Childhood benign gynaecological conditions are rare, yet their recogniton and correct management can have a huge impact on the individual's long-term reproductive health. Objective: To describe the experience with benign surgical gynaecological disorders in a tertiary health care institution. Study Design, Setting and Subjects: A descriptive analysis of 93 childhood benign gynaecological disorders that were surgically managed between 1st January 1989 and 31st December 1998 at the Maternity Hospital Wing of University of Ilorin Teaching Hospital, Ilorin, Nigeria. Result: Procedures to treat childhood benign gynaecological conditions accounted for 101 (2.6%) of the 3,919 gynaecological operations performed during the study period. The ages of the patients ranged from 8 months to 16 years. The three leading disorders were clitoridal cyst 26(28.0%), labial adhesion 21 (22.6%) and urethral mucosal prolapse 20 (21.5%). Others include vaginal laceration from rape 9 (9.7%), imperforate hymen 7 (7.5%), Bartholin abscess 5 (5.4%) and ovarian cysts 5 (5.4%). Conclusion: This study showed that childhood benign surgical gynaecological disorders are uncommon in our environment. Female circumcision was implicated as the aetiological factor in most of the patients suffering from the three commonest disorders. Discouraging female circumcision has the potential to significantly reduce the prevalence of paediatric gynaecological problems in Nigeria. Key Words: Paediatric Gynaecology, Congenital, Genital Tract [Trop J Obstet Gynaecol, 2003, 20: 37-39]

Group F Streptococcal Bacteremia Complicating a Bartholin′s Abscess

Background: Group F streptococci are Gram-positive cocci typically isolated from wound infections and abscesses. Bacteremia with group F streptococcus is uncommon, and the lower gynecologic tract has not been reported as a source. We report a case of a Bartholin's abscess leading to group F streptococcal bacteremia. Case: A 31-year-old female noted fever and rigors 30 min after manipulation of a 3-day-old vulvar abscess. An empty Bartholin's gland abscess was found on examination, and blood cultures grew β-hemolytic group F streptococci. The patient was treated with ampicillin/sulbactam, symptoms improved, and follow-up blood cultures revealed no growth. Conclusion: Group F streptococci are known to inhabit various body sites and have a predilection for forming abscesses; however, bacteremia is infrequent. They have occasionally been identified in true infections of the genitourinary tract but only very rarely in Bartholin's abscesses. This case of group F streptococcal bacteremia following self-drainage of a Bartholin's abscess constitutes the first such description in the medical literature.

A case of pelvic and hepatic abscesses following rollerball endometrial ablation

We present a case of a woman who underwent a seemingly uncomplicated rollerball endometrial ablation. She became unwell 4 days after the procedure. Ultrasound and computed tomography (CT) scans confirmed the presence of pelvic and hepatic abscesses. A right Bartholin's abscess was also found at this time and was subsequently marsupialized. This case highlights a previously unreported complication following rollerball endometrial ablation.

Needle Aspiration and Syndromic Management of Bartholin'S Abscess

A series of Bartholin's abscesses was managed on an outpatient basis by needle aspiration followed by triple antimicrobial therapy. The absence of Neisseria gonorrhoea was evident in 27.8 per cent of the cases. Based on the premise that Bartholin's abscess is to be treated as a sexually transmitted disease (STD), the choice of antimicrobials was made in line with the syndromic management of STDs. All the patients were reviewed after one week and two-thirds of them after six months. There was no long-term recurrence among the women who returned for follow-up. Client satisfaction was excellent. The procedure provides immediate relief, avoids hospitalisation and related costs, as well as the morbidity resulting from traditional surgical approaches. (Afr J Reprod Health 1999; 3 [1]: 103 - 108) Key Words : Bartholin's abscess, needle aspiration, sexually transmitted disease, syndromic management

Needle Aspiration and Syndromic Management of Bartholin's Abscess

Needle Aspiration and Syndromic Management of Bartholin's Abscess

Serum testosterone, DHEAS, and prolactin levels in patients with a Bartholin's abscess

Serum testosterone, DHEAS, and prolactin levels in patients with a Bartholin's abscess

Serum testosterone, DHEAS, and prolactin levels in patients with a Bartholin's abscess.

This study examines Prolactin and Androgen concentrations in 15 women with a Bartholin's gland abscess and in 15 matched normal controls. The Dehydroepiandrosterone sulfate concentrations were higher in the Bartholin's abscess group as compared to the concentrations in the control group [7.0 +/- 3.1 mmol/l versus 4.3 +/- 1.3 mmol/l (p < 0.05), respectively]. The Prolactin and the Testosterone levels did not differ statistically between the two groups.

Incidence of pelvic inflammatory disease among women treated for gonorrhea or chlamydia.

No estimate exists of the incidence of pelvic inflammatory disease (PID) after the occurrence of a recent bout of sexually transmitted disease (STD). We used a computerized data file of prescriptions and medical encounters from the Fallon Community Health Plan to estimate the incidence rate of pelvic inflammatory disease (PID) among women with a recently treated episode of gonorrhea or chlamydia (STD). First we identified women with presumed gonorrhea or chlamydia on the basis of a combination of diagnostic codes for cervicitis, vulvovaginitis or Bartholin's abscess, and a computer record of a prescription for doxycycline. We then followed these women to estimate the incidence rate of PID after their treatment for gonorrhea or chlamydia. We estimated the number of cases of pelvic inflammatory disease in this cohort by selecting all women with an International Classification of Diseases (ICD) code of 614.9 entered for either an outpatient or inpatient diagnosis. We estimated the overall risk of PID to be about 9% during the 1-year period following treatment for gonorrhea or chlamydia, with a steep rise in risk coming within the first 45 days. The risk of PID in the year after an episode of treated STD is high, but the highest period of risk is in the first few weeks. The shape of the risk curve indicates that some PID cases may result from treatment-resistant infections, or possibly from untreated reinfections.

Treatment of Bartholin's cyst and abscess: excision versus silver nitrate insertion

In a prospective randomized study, intracavitary silver nitrate (AgNO 3) stick insertion ( n = 25) was compared to the conventional excision technique ( n = 25) for Bartholin's cyst or abscess. Two groups were similar with regard to age, previous Bartholin's cyst/abscess and size of the cyst. Operation and healing time was significantly shorter in the AgNO 3 group ( P < 0.001, P < 0.001, respectively). Chemical burning in the vulva was observed in one patient in the AgNO 3 group, whereas hematoma on the operation site occurred in two patients in the excision group. Scar formation was found in two patients in whom excision was performed. Patients were followed for a period of 2 years and recurrence was not found in any of the cases in both groups. We conclude that, AgNO 3 insertion treatment for Bartholin's cyst and abscess is as effective as excision and is associated with fewer complications. Because it is simple and inexpensive, it is an attractive alternative treatment modality for this common gynecological disease.

Bartholin abscess due to CDC group HB-5

Bartholin abscess due to CDC group HB-5

Outpatient management of Bartholin gland abscesses and cysts with silver nitrate.

This study reports results of 52 patients with Bartholin abscesses or cysts who were managed by silver nitrate stick insertion into the cyst or abscess cavity for 48 hours. All patients showed complete healing within 15 days. However, 2 (3.8%) had recurrences within the first 2 months; 1 of these patients was treated with excision and the other by repetition of the same method with no further complaints. Silver nitrate application for Bartholin cysts or abscesses was found to be an effective, simple, inexpensive and the least anaesthetic requiring procedure, which can easily be carried out in the outpatient setting.

Microbiology of Bartholin′s Duct Abscess

Objective: The aim of the study was to determine the currently most frequent microbial findings in Bartholin's duct abscess. Methods: Computerized records of microbial findings of 249 cases of Bartholin's duct abscess were retrospectively studied. Results: In 129 cases, only 1 microbe and, in 117 cases, >1 microbe were recovered. In 3 cases, the flora was recorded as normal for the lower genital tract. Of all bacteria isolated, 252 were aerobic or facultative and 108 were anaerobic or microaerophilic. Aerobic or facultative bacteria alone caused 142 (57%) of the 249 cases, Escherichia coli being the most frequent isolate in this group. Anaerobic or microaerophilic bacteria alone caused 33 cases (13%), Bacteroides species and Prevotella species being most frequently identified. Both aerobic or facultative and anaerobic or microaerophilic bacteria were isolated in 70 cases (28%). Candida albicans alone caused 1 case of Bartholin's duct abscess. The sexually transmitted pathogens Neisseria gonorrhoeae and Chlamydia trachomatis were both involved in only 2 cases. Conclusions: Bartholin's duct abscess was mainly caused by opportunistic bacteria, and sexually transmitted pathogens were only rarely involved in its pathogenesis. Since potentially pathogenic bacterial species were also frequently isolated, the use of antibiotics to complement the surgical treatment of Bartholin's duct abscess seems advisable, especially in patients with systemic symptoms.

Bartholinʼs Duct Abscess and Cyst

Little is known about the epidemiology of Bartholin's duct abscess and cyst. We did an emergency department-based case-control study to examine demographic risk factors for this condition. We found that risk varied by age. After adjustment for pregnancy status, the relative odds (odds ratio [OR]) of occurrence of Bartholin's duct abscess for women 20 to 29 years old, compared to women younger than 20 years, was 2.3. The association was weaker among women in their 30s and 40s (OR = 1.4 and 1.1, respectively). The majority of patients were Hispanic whites (66% of cases and 79% of control subjects). Risk of Bartholin's duct abscess was greater among non-Hispanic white women (OR = 1.9) and black women (OR = 2.4). At lowest risk of this condition were women with high parity (> or = 4) or high gravidity (> or = 5). These findings suggest that the risk factor profile of this condition is similar to that of most sexually transmitted diseases. The advisability of presumptive antibiotic treatment of these patients and examination and treatment of their sexual partners should be considered.

Isolation of Salmonella Group E from Bartholin Abscess

Isolation of Salmonella Group E from Bartholin Abscess

Vulvar leiomyoma

Since symptoms of benign and malignant conditions in the vulvar area are frequently similar, early diagnosis and treatment are mandatory. A rare case of a bizarre leiomyoma in the area of Bartholin's gland, which presented as a Bartholin's abscess, is described and discussed.

Black-pigmented Gram-negative anaerobes in genito-urinary tract and pelvic infections

Black-pigmented Gram-negative anaerobes are part of the normal vaginal flora and contribute to a range of superficial and deep genital infections. Prevotella melaninogenica is found in moderate numbers (104−6 cfu/g) in healthy women; the numbers and detection rates increase in anaerobic vaginosis (where it may be a significant contributor to changed microbial metabolic activity that gives the signs and symptoms of this condition) and in other vaginal infective conditions. Pr. melaninogenica is also part of the mixed flora in deep pelvic infections: endometritis, post-partum and post-abortal uterine infections; salpingitis and tubo-ovarian abscesses; PID and pelvic abscesses. Porphyromonas asaccharolytica is probably not a vaginal commensal, but may be isolated from patients with vaginal or pelvic disease. It is more specifically associated with superficial abscesses (e.g. Bartholin's abscess) and ulcers of the genitalia and perineum. P. asaccharolytica was the commonest species isolated from men with genital ulcers of various primary causes and ranging in severity from superficial balanitis/balanoposthitis to synergic gangrene.

Black-pigmented Gram-negative anaerobes in genito-urinary tract and pelvic infections

Black-pigmented Gram-negative anaerobes are part of the normal vaginal flora and contribute to a range of superficial and deep genital infections. Prevotella melaninogenica is found in moderate numbers (10(4-6) cfu/g) in healthy women; the numbers and detection rates increase in anaerobic vaginosis (where it may be a significant contributor to changed microbial metabolic activity that gives the signs and symptoms of this condition) and in other vaginal infective conditions. Pr. melaninogenica is also part of the mixed flora in deep pelvic infections: endometritis, post-partum and post-abortal uterine infections; salpingitis and tubo-ovarian abscesses; PID and pelvic abscesses. Porphyromonas asaccharolytica is probably not a vaginal commensal, but may be isolated from patients with vaginal or pelvic disease. It is more specifically associated with superficial abscesses (e.g. Bartholin's abscess) and ulcers of the genitalia and perineum. P. asaccharolytica was the commonest species isolated from men with genital ulcers of various primary causes and ranging in severity from superficial balanitis/balanoposthitis to synergic gangrene.

Vulval leiomyosarcoma presenting as a recurrent Bartholin's abscess

Vulval leiomyosarcoma presenting as a recurrent Bartholin's abscess

Microbial resistance surveillance techniques: Blood culture versus multiple body site monitoring

The continuing problem of nosocomial bacterial infections has resulted in the development of new techniques to monitor their prevalence and detect the emergence of drug resistance. "Focused microbial surveillance," in which bacterial incidence and antimicrobial susceptibilities are assessed by specific hospital units, provides unique information in the evaluation of emerging outbreaks of resistant Gram-negative pathogens. Within a given unit, however, pooled microbiologic data may be misleading, since they reflect only the average of multiple susceptibilities and may represent either colonization or infection. Formerly, at the University of Iowa Hospitals and Clinics, bacterial surveillance within a particular unit had typically been performed using blood-sample analysis, which was viewed as an effective index of the activity of most classes of antimicrobial agents. However, specific body site surveillance (wounds, sputum, urine, and so forth) may offer advantages over blood-culture analysis with some forms of resistance (or types of bacteria), such as stably derepressed type-I beta-lactamase production, which seems to develop rather quickly. Site-specific surveillance may enable earlier detection of rapidly emerging resistant strains and the identification of virulent new serotypes or specific causes. Our data demonstrated that there is a greater probability of detecting resistant bacterial strains of Enterobacter colonizing and subsequently producing infections in the respiratory tract, urinary tract, or wound site. There was a time delay of almost 3 years between first observing resistant strains in sputum, urine, or pus and encountering them in an alarming incidence among blood cultures. Other studies confirm this particular phenomenon. In a survey of penicillin-resistant enterococci, the majority of clinical isolates were obtained from sites other than blood: seven from urine; five from wounds; two each from rectal swabs, ascitic fluid, and blood; and one each from a peritoneal catheter, Bartholin's cyst abscess, and pancreatic abscess. Effective techniques for selective surveillance should be both sensitive and cost effective. Current evidence suggests that site-specific monitoring (wounds, sputum, pleural effusions, urine, and feces) offers the advantages of more rapid identification of resistance trends prior to their appearance in the bloodstream cultures.