Tubo-ovarian Abscess Formation Research Articles

Ovarian Tube Abscess in an Intrauterine Contraceptive Device User for 5 Years: A Case Report

A tubo-ovarian abscess (TOA) is one of the late complications of untreated Pelvic Inflammatory Disease (PID) and can be life-threatening if the abscess ruptures and results in sepsis.1 It most commonly affects women of reproductive age and nearly 60% of women with TOA are nulliparous.2 The association between tubo-ovarian abscess formation and the presence of an intrauterine device (IUD) is well recognized. It has been suggested that the risk of upper genital tract infection is highest during the immediate period following the insertion of an IUD. We report a case of pelvic inflammatory disease in a 44-year-old woman using an intrauterine contraceptive device (IUD) for more than 5 years, who complained of lower abdominal pain and lumbar pain without fever, and also had a thick-white vaginal discharge. The clinical diagnosis was performed by anamnesis and ultrasound (we found an hypo- hyperechoic mass on the right adnexa size 4.4 x 3.6 x 4.0 cm) and then the patient was treated with triple antibiotics for 3 days. Afterward, the patient was performed using exploring laparoscopy to continue to right salpingo-oophorectomy adhesiolysis left tubectomy, and IUD removal as well. Long-term users of IUDs remain at risk for serious pelvic infections. Every IUD user's patient should be routinely counseled by their gynecologist and tubo-ovarian abscess should be strongly considered in the differential diagnosis of an IUD user who presents with an adnexal mass, abdominal pain, and lumbar pain. The treatment must be a combination of antibiotics and surgery.

Tubo-Ovarian Abscess Caused by Pasteurella multocida in a Young, Intrauterine Device–Wearing Woman Without Animal Contact

Abstract Tubo-ovarian abscesses are usually caused by anaerobic bacteria alone or in mixed infection. Here, we report about a successfully treated 29-year-old patient with bilateral tubo-ovarian abscess caused by Pasteurella multocida. She had no exposure to animals. After the removal of a 1-year-old copper-T intrauterine device at the time of hospitalization, total abdominal hysterectomy and bilateral salpingo-oophorectomy were performed by laparotomy because of the level of the inflammatory lesion of both ovaries. After the administration of antibiotic combination, the patient was discharged home on the fifth postoperative day. In the setting of a tubo-ovarian abscess, rare zoonotic pathogens, such as P. multocida, should also be considered as a causative agent of the infectious process even in the absence of direct or indirect contact with animals. It seems that the asymptomatic colonization of the vagina and the intrauterine device with P. multocida may happen also from unknown origin of the environment with the consequences of severe pelvic infection with tubo-ovarian abscess formation.

Is intrauterine device a risk factor for failure of conservative management in patients with tubo-ovarian abscess? An observational retrospective study

Tubo-ovarian abscess (TOA) is a serious and potentially life-threatening complication of pelvic inflammatory disease (PID). TOA formation may be an uncommon, but serious complication associated with the use of an intrauterine device (IUD). While the majority of TOA respond to antibiotic therapy, in approximately 25% of cases surgery or drainage is indicated. In the present study, we compared the failure rate of conservative management in patients with and without IUD, who were admitted with a diagnosis of TOA. In this retrospective case-control study, 78 women were diagnosed with TOA. All patients were treated initially by broad-spectrum intravenous antibiotics. The failure of conservative management after 72h was followed by surgical intervention. The patients were divided into two groups: 24 patients were IUD-carriers, and 54 did not use IUD. There was no significant difference in surgical intervention rate between IUD group (50%) and no-IUD group (43%), p=0.32. The WBC count was significantly higher in IUD-carriers diagnosed with TOA than in patients without IUD (16.5±6.6 vs. 13.1±4.6, p=0.001). The patients with IUD had significantly larger abscesses as revealed by ultrasound than patients without IUD (61.6±21.4 vs. 49.6±20.6mm, p=0.02). The surgical intervention rate in TOA patients with and without IUD was similar.

An Unusual Case of a Forgotten IUCD for 22 Years

Background: Reliable, reversible most widely used, contraceptive method worldwide is intrauterine device (IUCD). The association between tubo ovarian abscess formation and the presence of an intrauterine device is well recognized. Case Report: We report a case of forgotten IUCD for 22 years in 41 years woman with Tubo Ovarian mass. No history suggestive of STD or chronic illness or immunocompromised condition. After first child (22 years ago) she never conceived, had on and off abdominal pain, patient was unaware of IUCD insertion and did not had any gynaec checkup. She was admitted for abdominal pain since 2 days. Abdominal palpation revealed vague tenderness in left iliac region and mass about 8x6 cm size. No guarding or rigidity. Her pelvic examination revealed the IUCD string with mild discharge and IUCD was removed. Bimanual examination revealed marked cervical motion tenderness and left adnexal tender. Tense mass felt per abdomen was felt per vaginum. Rectal examination was normal. USG - Abdomen and Pelvis-complex TO mass left side about 5cmx8cm with minimal fluid on POD. Patient was on IV fluids and parenteral antibiotics. After two days patient developed general peritonitis, hence emergency Laparotomy was done. After informed consent Total abdominal Hysterectomy with omentectomy was done. Histopathology confirmed bilateral tubo ovarian abscess and Omentum - Micro abscess. Conclusion: Only after concerned IUCD to be introduced and long-term users of IUCDs remain at risk for serious, indolent pelvic infections and hence counseling should be given before insertion and need for follow up should be stressed.

Colonic Diverticulitis Complicating Colo-ovarian Fistula and Tuboovarian Abscess Formation in on Old Woman

The inflammation of colonic diverticulum, diverticulitis, is occasionally accompanied by several complications, such as bleeding, bowel obstruction, fistula and abscess formation. Both colo-ovarian fistula and tuboovarian abscess formation, as complications of diverticulitis, are rare. Here, we report a case of colonic diverticulitis which ultimately resulted in colo-ovarian fistula and tuboovarian abscess formation. A 76-year-old female was presented with lower abdominal pain, diarrhea and intermittent hematochezia for about 1 month. According to the abdominal computed tomography, tuboovarian abscess was shown to adhere to the inflamed sigmoid diverticulum. Sigmoidoscopy revealed pus flowing from the opening of the diverticulum at the sigmoid colon. Hence, the patient underwent oophorosalpingectomy and low anterior resection. Thereafter, she was treated with bowel rest and broad spectrum antibiotics, and finally recovered. Although rare, colonic diverticulitis may result in colo-ovarian fistula causing tuboovarian abscess formation in postmenopausal patients. Early recognition of the condition and appropriate treatment, including surgery and antibiotics, are necessary in order to achieve full recovery from complicated diverticulitis.

Pelvic inflammatory disease in the postmenopausal woman.

OBJECTIVE: Review available literature on pelvic inflammatory disease in postmenopausal women. DESIGN: MEDLINE literature review from 1966 to 1999. RESULTS: Pelvic inflammatory disease is uncommon in postmenopausal women. It is polymicrobial, often is concurrent with tuboovarian abscess formation, and is often associated with other diagnoses. CONCLUSION: Postmenopausal women with pelvic inflammatory disease are best treated with inpatient parenteral antimicrobials and appropriate imaging studies. Failure to respond to antibiotics should yield a low threshold for surgery, and consideration of alternative diagnoses should be entertained.

Ruptured tubo-ovarian abscess complicating transcervical cryopreserved embryo transfer

To present a rare infectious complication related to transcervical ET, without prior transvaginal puncture. Case report. Hadassah University Hospital, IVF-ET unit. One patient undergoing cryopreserved-thawed ET. Artificial preparation of the endometrium with E2 and P, followed by transcervical intrauterine cryopreserved-thawed embryo transfer. After ET, severe pelvic inflammatory disease (PID) with ruptured tubo-ovarian abscess was diagnosed and treated. Severe PID including tubo-ovarian abscess formation should be considered a potential complication after ET, even without transvaginal oocyte aspiration.

Tubo-ovarian abscess formation in users of intrauterine devices remote from insertion: A report of three cases

Background The association between tubo-ovarian abscess formation and the presence of an intrauterine device (IUD) is well recognized. It has been suggested that the risk of upper-genital-tract infection is highest during the immediate period following the insertion of an IUD, returning to baseline by 5 months postinsertion. We present 3 cases of women who, 10–21 years after insertion of their IUDs, developed tubo-ovarian abscesses that were not causally related to sexually transmitted diseases (STDs) or actinomycetes. Cases: Three women, ages 39–47 years, presented to our gynecology service for evaluation of abdominal pain. One woman had bilateral tubo-ovarian abscesses and the other 2 had unilateral tubo-ovarian abscesses. All 3 were IUD users, with an interval from IUD insertion to presentation of 10–21 years. In each case, the cervical cultures for gonorrhea and chlamydia were negative at presentation and the sexual history was not consistent with an STD mode of spread. All 3 women initially received broad-spectrum antibiotics, but 2 eventually required definitive surgical therapy. Conclusion Long-term users of IUDs remain at risk for serious, indolent pelvic infections. These women should be counseled by their gynecologists on an ongoing basis as to this persistent risk. Tubo-ovarian abscess should be strongly considered in the differential diagnosis of an IUD user who presents with an adnexal mass, fever, or abdominal pain. © 1996 Wiley-Liss, Inc.

Tubo‐Ovarian Abscess Formation in Users of Intrauterine Devices Remote From Insertion: A Report of Three Cases

Background: The association between tubo-ovarian abscess formation and the presence of an intrauterine device (IUD) is well recognized. It has been suggested that the risk of upper-genital-tract infection is highest during the immediate period following the insertion of an IUD, returning to baseline by 5 months postinsertion. We present 3 cases of women who, 10–21 years after insertion of their IUDs, developed tubo-ovarian abscesses that were not causally related to sexually transmitted diseases (STDs) or actinomycetes. Cases: Three women, ages 39–47 years, presented to our gynecology service for evaluation of abdominal pain. One woman had bilateral tubo-ovarian abscesses and the other 2 had unilateral tubo-ovarian abscesses. All 3 were IUD users, with an interval from IUD insertion to presentation of 10–21 years. In each case, the cervical cultures for gonorrhea and chlamydia were negative at presentation and the sexual history was not consistent with an STD mode of spread. All 3 women initially received broad-spectrum antibiotics, but 2 eventually required definitive surgical therapy. Conclusion: Long-term users of IUDs remain at risk for serious, indolent pelvic infections. These women should be counseled by their gynecologists on an ongoing basis as to this persistent risk. Tubo-ovarian abscess should be strongly considered in the differential diagnosis of an IUD user who presents with an adnexal mass, fever, or abdominal pain.

Pelvic Inflammatory Disease

--To examine available data regarding optimal antimicrobial therapy for pelvic inflammatory disease (PID) and to address selected treatment issues confronting clinicians caring for women with PID.--Studies evaluated to help establish the Centers for Disease Control's 1989 Sexually Transmitted Diseases Treatment Guidelines and other reports published since 1985. A MEDLINE search of English-language literature was conducted using the indexing terms "pelvic inflammatory disease" or "pelvic infections" or "salpingitis" and "treatment". In addition, abstracts and bibliographies of articles and books were reviewed.--Studies were selected for detailed review if they evaluated the effectiveness of an antimicrobial regimen for treatment of PID.--All studies were evaluated to determine the numbers of women treated and the percentage with clinical or microbiologic evidence of cure.--A variety of combination antimicrobial regimens are highly effective in providing clinical and microbiologic evidence of cure; few data are available to assess optimal therapy for prevention of late sequelae. Because PID is polymicrobial in cause, recommended antimicrobial regimens are broad-spectrum in coverage.--No single agent that provides sufficient coverage is currently available. Several combination regimens appear highly effective clinically even among women with tubo-ovarian abscess formation. Uncertainties regarding the effectiveness of antimicrobial therapy for prevention of late sequelae complicate decisions regarding the choice among regimens and the appropriateness of ambulatory treatment of women with PID. Pending better data, hospitalization should be strongly considered, where feasible, particularly for those women with PID desiring further childbearing. Sex partners of all women with PID should be treated.

Pelvic inflammatory disease. Key treatment issues and options.

--To examine available data regarding optimal antimicrobial therapy for pelvic inflammatory disease (PID) and to address selected treatment issues confronting clinicians caring for women with PID. --Studies evaluated to help establish the Centers for Disease Control's 1989 Sexually Transmitted Diseases Treatment Guidelines and other reports published since 1985. A MEDLINE search of English-language literature was conducted using the indexing terms "pelvic inflammatory disease" or "pelvic infections" or "salpingitis" and "treatment". In addition, abstracts and bibliographies of articles and books were reviewed. --Studies were selected for detailed review if they evaluated the effectiveness of an antimicrobial regimen for treatment of PID. --All studies were evaluated to determine the numbers of women treated and the percentage with clinical or microbiologic evidence of cure. --A variety of combination antimicrobial regimens are highly effective in providing clinical and microbiologic evidence of cure; few data are available to assess optimal therapy for prevention of late sequelae. Because PID is polymicrobial in cause, recommended antimicrobial regimens are broad-spectrum in coverage. --No single agent that provides sufficient coverage is currently available. Several combination regimens appear highly effective clinically even among women with tubo-ovarian abscess formation. Uncertainties regarding the effectiveness of antimicrobial therapy for prevention of late sequelae complicate decisions regarding the choice among regimens and the appropriateness of ambulatory treatment of women with PID. Pending better data, hospitalization should be strongly considered, where feasible, particularly for those women with PID desiring further childbearing. Sex partners of all women with PID should be treated.