DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20211165

Pelvic abscess in a sexually inactive teenage girl: a case report and review of literature

Monika Anant, Kajal Sinha

Abstract


Pelvic abscess, a potentially life-threatening collection of infected exudate in pelvic organs, commonly occurrs in sexually active women having pelvic inflammatory disease due to sexually transmitted infections. It is rare to find it in a girl never engaged in sexual activity. The index case was a of pelvic abscess in a 15year virgin girl. She presented with fever abdominal pain and lump. Ultrasonography suggested a complex pelvic mass but on CT imaging pelvic abscess was confirmed. She underwent surgical intervention after failed medical treatment to drain the collection and preservation of internal genital organs. Pelvic abscesses demand prompt diagnosis and management to prevent further complications and long-term poor fertility outcomes specially at young age and should be a differential diagnosis in girls with pain abdomen and fever.


Keywords


Virgin, Pelvic abscess, Antibiotics, Surgical drainage

Full Text:

PDF

References


Akıncı D, Ergun O, Topel Ç, Çiftçi T, Akhan O. Pelvic abscess drainage: outcome with factors affecting the clinical success. Diagn Interv Radiol. 2018;24(3):146-52.

Soper DF. Genitourinary infections and sexually transmitted diseases. In: Berek JS: Novak's Gynecology, 14th Ed. Philadelphia; Lippincott Williams & Wilkins. 2007;549-52.

Hartmann KA, Lerand SJ, Jay MS. Tubo-Ovarian Abscess in Virginal Adolescents: Look for Underlying Etiology. J Pediatr Adolesc Gynecol. 2007;20:127.

Cho HW, Koo YJ, Min KJ, Hong JH, Lee JK. Pelvic inflammatory disease in virgin women with tubo-ovarian abscess: a single-center experience and literature review. J Pediatr Adolesc Gynecol. 2017; 30:203-8.

Canas AM, Holloran-Schwartz B, Myles T SO. Tuboovarian abscess 12 years after total abdominal hysterectomy.AU Obstet Gynecol. 2004;104(5 Pt 1):1039.

Dogan E, Altunyurt S, Altındag T, Onvural A. Tubo-ovarian Abscess Mimicking Ovarian Tumor in a Sexually Inactive Girl. J Pediatr Adolesc Gynecol. 2004;17:351-2.

Arda IS, Ergeneli M, Coskun M, Hicsonmez A. Tubo-ovarian abscess in a sexually inactive adolescent patient. Eur J Pediatr Surg. 2004;14:70-72.

Meis J, Festen C, Hoogkamp-Korstanje J. Pyosalpinx caused by Streptococcus pneumoniae in a young girl. Pediatr Infect Dis J. 1993;12:539-40.

Bugg CW, Taira T, Zaurova M. Pelvic inflammatory disease: diagnosis and treatment in the emergency department (digest). Emerg Med Pract. 2016;18(12):S1-S2.

Wiesenfeld HC, Sweet RL. Progress in the management of tuboovarian abscesses. Clin Obstet Gynecol. 1993;36(2):433.

Hsu WC, Lee YH, Chang DY. Tuboovarian abscess caused by Candida in a woman with an intrauterine device. Gynecol Obstet Invest. 2007;64(1):14.

Thaneemalai J, Asma H, Savithri DP. Salmonella tuboovarian abscess.AU Med J Malaysia. 2007;62(5):422.

Myckan KA, Booth CM, Mocarski E. Pasteurella multocida bacteremia and tuboovarian abscess. Obstet Gynecol. 2005;106(5 Pt 2):1220.

Demirtas O, Akman L, Demirtas GS, Hursitoglu BS, Yilmaz H. The role of the serum inflammatory markers for predicting the tubo-ovarian abscess in acute pelvic inflammatory disease: a single-center 5-year experience. Arch Gynecol Obstet. 2013;287(3):519-23.

Hiller N, Sella T, Lev-Sagi A, Fields S, Lieberman S. Computed tomographic features of tuboovarian abscess. J Reprod Med. 2005;50(3):203-8.

Chappell CA, Wiesenfeld HC. Pathogenesis, diagnosis, and management of severe pelvic inflammatory disease and tuboovarian abscess. Clin Obstet Gynecol. 2012;55(4):893-903.

Chappell CA, Wiesenfeld HC. Pathogenesis, diagnosis, and management of severe pelvic inflammatory disease and tuboovarian abscess. Clin Obstet Gynecol. 2012;55(4):893-903.

Lee DC, Swaminathan AK. Sensitivity of ultrasound for the diagnosis of tubo-ovarian abscess: a case report and literature review. J Emerg Med. 2011;40(2):170-5.

Goharkhay N, Verma U, Maggiorotto F. Comparison of CT- or ultrasoundguided drainage with concomitant intravenous antibiotics vs. intravenous antibiotics alone in the management of tubo-ovarian abscesses. Ultrasound Obstet Gynecol. 2007;29:65-9.

Fouks Y, Cohen A, Shapira U, Solomon N, Almog B, Levin I Surgical Intervention in Patients with Tubo-Ovarian Abscess: Clinical Predictors and a Simple Risk Score. J Minim Invasive Gynecol. 2019;26(3):535.

Casola G, van Sonnenberg E, D’Agostino HB, Parker CP, Varney RR, Smith D. Percutaneous drainage of tubo-ovarian abscesses. Radiology. 1992;182:399-402.

Rosen M, Breitkopf D, Waud K. Tubo-ovarian abscess management options for women who desire fertility. Obstet Gynecol Surv. 2009;64(10):681-9.