An extremely rare case of tubo-ovarian abscesses involving corynebacterium striatum as causative agent

Abstract

Background: We present an extremely rare case of tubo-ovarian abscesses involving Corynebacterium striatum (C. striatum) as causative agent in a 53-year-old woman.

Case presentation: The patient presented with stomach pain, chills, and nausea. Her medical history included poorly controlled psoriasis vulgaris and diabetes. Laboratory and imaging findings led to diagnosis of septic shock due to tubo-ovarian abscesses. She was treated with antibiotic therapy and surgery to remove the left adnexa. Various cultures detected Prevotella spp. and C. striatum. We concluded that C. striatum from skin contaminated by psoriasis vulgaris had caused the tubo-ovarian abscesses by way of ascending infection.

Conclusions: This may be the first known case of tubo-ovarian abscesses due to C. striatum. In patients whose skin has been weakened by psoriasis vulgaris or other infections, Corynebacterium should be considered as causative microorganisms, and antibiotic therapy including vancomycin should be administered.

Keywords: Corynebacterium striatum; Psoriasis vulgaris; Tubo-ovarian abscesses; Upper reproductive tract infection.

Fig. 1

Photographs of the patient’s back (a) and right knee (b) 1 year prior to admission, showing poorly controlled psoriasis vulgaris

Fig. 2

Computed tomographic and magnetic resonance imaging findings on admission. a Computed tomography scan of the abdomen and pelvis, showing a 38 × 44-mm tumor surrounded by dense adipose tissue (red circle) in the left adnexa. The previously noted right ovarian abscess also is seen (yellow arrows). b Coronal T2-weighted contrast-enhanced magnetic resonance image of the pelvis, showing edematous change (red arrows) surrounded by liquid formation (blue arrowheads) in the left adnexa. The previously noted right ovarian abscess also is seen (yellow arrows)

Fig. 3

Gross findings of the surgical specimens. a Ovarian abscess. b Ovarian abscess section surface

Fig. 4

Summary of the patient’s clinical course from admission through day 25. Although her blood pressure decreased before surgery, her hemodynamics slowly stabilized after surgery. On day 15, she was moved from the high care unit to a general patient wing. In accordance with the blood culture results, treatment proceeded with ampicillin/sulbactam and vancomycin. Blood cultures on day 8 were negative. Abbreviations: ABPC/SBT, ampicillin/sulbactam; BT, body temperature; MEPM, meropenem; MINO, minocycline; NAD, noradrenalin; sBP, systolic blood pressure; VCM, vancomycin