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Case Reports
. 2006:2006:84140.
doi: 10.1155/IDOG/2006/84140.

Endometrioma complicated by tubo-ovarian abscess in a woman with bacterial vaginosis

Shahryar K Kavoussi  1 , Mark D Pearlman, William M Burke, Dan I Lebovic
Affiliations
Case Reports

Endometrioma complicated by tubo-ovarian abscess in a woman with bacterial vaginosis

Shahryar K Kavoussi et al. Infect Dis Obstet Gynecol. 2006.

Abstract

Background: Tubo-ovarian abscess involvement of an endometrioma has been reported in cases of patients with polymicrobial sources such as Neisseria gonorrhoeae, Chlamydia trachomatis, and obligate anaerobic bacteria; however, bacterial vaginosis (BV) predisposing to abscess formation in an endometrioma has not been reported to date.

Case: Superinfection of an endometrioma was surgically diagnosed in a patient with known advanced-stage endometriosis after she presented with acute pelvic inflammatory disease symptoms and was unresponsive to antibiotic therapy. Gram-negative rods were cultured from the endometrioma. On admission, cervical, blood, and urine cultures were negative; BV was diagnosed on normal saline wet prep and gram stain.

Conclusion: This case raises the possibility of BV ascension to the upper genital tract predisposing to abscess formation in endometriomas. Therefore, aggressive treatment of BV in patients with known advanced-stage endometriosis may be considered to prevent superinfected endometriomas.

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Figures

Figure 1
Figure 1
(a) Transvaginal ultrasound image, shortly after initial evaluation, of persistent bilateral ovarian masses adjacent to uterus (Ut). (b) Ultrasound image of left ovarian cystic structure after patient presented with symptoms of acute pelvic inflammatory disease.
Figure 2
Figure 2
Endometrioma with associated edema, hemorrhage, acute inflammation, and marked eosinophilia (H & E, ×40).
See this image and copyright information in PMC

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