Tubo-ovarian abscess infected by Salmonella typhi.

We report a case of a tubo-ovarian abscess infected with Salmonella enterica serotype typhi A 19-year-old Nepalese woman presented to a hospital in Kathmandu with lower abdominal pain, constipation, fever and a non-healing, suppurative surgical wound from an emergency caesarian section performed 2 months previously at 37 weeks of pregnancy. She also had an exploratory laparotomy for an appendix perforation with peritonitis at 25 weeks of gestation. Her wound infection did not respond to cloxacillin and she had an exploratory laparotomy, and a tubo-ovarian abscess was found from which S. typhi was isolated. She had a bilateral salpingo-oophorectomy and responded to 14 days of chloramphenicol. A tubo-ovarian abscess is a rare complication of enteric fever.

Tubo-ovarian abscess during therapy of chronic hepatitis C with pegylated interferon and ribavirin.

BACKGROUND: Serious infections are rare complications of standard treatment in chronic hepatitis C with pegylated interferon alpha (Peg IFN) and ribavirin. CASE: We report two cases of life-threatening tubo-ovarian abscess (TOA) in women older than 40 year of age. No casual risk factors of TOA could be identified in them. In one case septic shock and acute renal failure occured. TOA was caused by endogenic bacteria (Porphyromonas asaccharolytica in the first case and Streptococcus intermedius in the latter). Surgical treatment and interruption of IFN therapy was necessary in both cases. CONCLUSIONS: Serious gynecological infections may have the significant negative influence on chronic hepatitis C therapy outcome. Because of the risk of TOA developing during IFN therapy gynecological care is needed in chronic hepatitis C management.

[Unilateral salpingian and ovarian TB, a rare form of extrapulmonary TB]. / Salpingo--ovarita bacilara unilaterala, forma, rara de tuberculoza extrapulmonara.

TB salpingitis and ovarian TB is a rare association of extrapulmonary tuberculosis, especially when the lesions are not associated with lung involvement. The correct therapy leads to the sterilization of the tuberculosis foci, although the risk of scars and adhesions is high, causing local functional disorders.

Tuboovarian abscess caused by Candida in a woman with an intrauterine device.

Candida infection should be considered in an individual with a pelvic abscess that is unresponsive to conventional antibiotic therapy, particularly in the presence of an intrauterine device. We present a case of a tuboovarian abscess caused by Candida species in a woman with an intrauterine device for >10 years. Surgical intervention followed by antifungal therapy resulted in a favorable outcome.

Etiology of persistent tubo-ovarian abscess in Nairobi, Kenya.

OBJECTIVE: To study the microbial etiology of tubo-ovarian abscess (TOA). METHODS: We recruited 11 women in Nairobi, Kenya who failed antibiotic therapy alone and required surgical drainage of a presumptive TOA. Pus from the nine abscesses and two pyosalpinges were collected and cultured for aerobic, facultative and anaerobic microorganisms. RESULTS: Eleven women suspected of having a TOA were hospitalized and treated for a median of 6 days (range 3-14 days) prior to surgical drainage of the abscess. Nine (82%) specimens were culture positive. Aerobes were present in all nine specimens. Seven of the nine positive cultures (78%) were polymicrobial and five of the polymicrobial cultures contained both anaerobes and aerobes. Anaerobic Gram-negative bacilli (Prevotella sp., Porphyromonas sp. and Bacteroides sp., Escherichia coli) and Streptococcus sp. (S. viridans and S. agalactiae) were the most common microorganisms isolated. Neisseria gonorrhoeae and Chlamydia trachomatis were not isolated by culture or detected by polymerase chain reaction. CONCLUSIONS: In Kenya, persistent TOAs are associated with endogenous flora similar to that normally found in the gastrointestinal tract.

[Characteristics of enterobacteria isolated from patients with urogenital pathology]. / Kharakteristika énterobakterii, vydelennykh ot bol'nykh s urogenital'noi patologiei.

Species composition and a number of persistence characteristics enterobacteria isolated from urine of 42 pregnant and 22 nonpregnant women with pyelonephritis (relapse, remission), from prostatic fluid of 225 males and secretions of cervical canal of 124 women with urogenital pathology (prostatitis, salpingo-oophoritis) were studied. The study revealed that enterobacteria, including Escherichia coli, prevailed in the structure of uromicroflora (66.7-83.3%) and constituted a relatively small proportion among "genital" isolates of microorganisms (19.9-22.2%). Male and female sterility and the presence of enterobacteria in the reproductive tract of patients were found to be directly correlated. Clinical isolates of enterobacteria were shown to possess pronounced seroresistance and the complex of persistence characteristics, including antilysozyme, anti-intercidal and anticomplementary activity.

[A case report of Campylobacter fetus subspecies fetus oophoritis].

A 45-year-old female with oophoritis (pelvic inflammatory disease) caused by Campylobacter fetus (C. fetus) is reported. She was admitted to the hospital because of high fever and an acute abdomen. On admission, severe inflammation was observed by the laboratory findings, and abdominal X-ray and CT scan revealed ileus with marked swelling of the right ovary. Laparotomy was performed with adonexooophrectomy due to the tubo-ovarian abscesses. C. fetus was isolated from the right ovary, salpinx and ascites. Erythromycin was administered after a sensitive test of C. fetus as the bacteria was isolated at operation. She was discharged on the 17th day after her admission. Indirect immunofluorescent test with hyperimmune rabbit sera to isolated C. fetus revealed a fine to coarse granular immunoreaction in the cytoplasm of the macrophages infiltrated in the tissue. This result was interpreted as the existence and growth of bacteria in the right ovarian tissue. Oophoritis due to C. fetus subspecies fetus is very rare. To our knowledge, this case is the second case reported in Japan.

[Mycobacterial antigens and antitubercular antibodies in patients with tuberculosis salpingo-oophoritis]. / Antigeny mikobakterií i protivotuberkuleznye antitela u bol'nykh tuberkuleznym sal'pingooforitom.

Sixty two and 59 patients with tuberculous and nontuberculous salpingo-oophoritis, respectively, and 30 healthy females were examined. It was found that indirect solid-phase enzyme immunoassay (EIA) using ultrasonography of Mycobacterium tuberculosis H37Rv could detect antituberculosis antibodies in 66.7% of patients with tuberculous salpingo-oophoritis, and in 10% of healthy females. That using the antigen isolated from the cell wall extract of M. tuberculosis (whose molecular weight was 38 - 42 kD) could reveal them in 70.2, 4.3%, and 6.7%, respectively. After dissociation of immune complexes, EIA inhibition using affinity-purified antimycobacterial antisera displayed mycobacterial antigens in 75.0 and 4.3% of patients with tuberculous and nontuberculous salpingo-oophoritis, respectively, and in none healthy female. Thus, the detection of mycobacterial antigens and antituberculosis antibody may be successfully used in the complex diagnosis of tuberculosis of the female genitals.

Tuboovarian abscess and peritonitis caused by Streptococcus pneumoniae serotype 1 in young girls.

Streptococcus pneumoniae is a frequent bacterial cause of pneumonia, bacteremia, meningitis, and otitis media in infants and children. Primary pneumococcal peritonitis, however, is rare in children and is usually associated with an underlying medical condition (such as nephrotic syndrome) or with upper genital tract disease in females, Pneumococcal upper genital tract infections in the premenarchal child are extremely unusual. Epidemiologic reviews of pneumococcal serotypes causing infection in children have indicated that serotype 1 is an uncommon pathogen of pelvic disease in children. We describe three children who presented with abdominal pain and a toxic appearance; appendicitis was initially suspected in all three children, but peritonitis due to S pneumoniae serotype 1 was subsequently diagnosed in all three. Each child had a tuboovarian abscess that was demonstrated radiographically. Two children had complicated courses, but all ultimately recovered. The epidemiology and possible tropism of serotype 1 isolates for the female upper genital tract are discussed.

[Treatment of endometritis and salpingo-oophoritis monitored by the antilysozyme activity of the agents]. / Lechenie endometrita i sal'pingooforita pod kontrolem antilizotsimnoiaktivnosti vozbuditelia.

The authors suggest new methods for the choice of drugs and physiotherapeutic modalities for the treatment of female genital inflammations, based on the suppression of the agents' antilysozymic activities, factors of the agent intracellular persistence. Clinical trials of these methods in 91 patients have shown their high efficacy: the incidence of complete remissions has increased by 60.7%, incidence of disease recurrences reduced by 53%, and remission periods in chronic patients were prolonged by 2.5-3 times (from 0.5-1 year to 2.5-3 years).

Isolation of mumps virus from vaginal secretions in association with oophoritis.

Mumps virus was isolated from the cervico-vaginal secretions of a 31-year-old woman presenting with mild signs of oophoritis accompanied by xantholeucorrhoea. The serological finding of mumps-specific IgM antibodies was further evidence confirming the casual link between mumps virus and ovarian pathology. Rarely, ovarian involvement may be the only manifestation of mumps infection. The importance of this diagnosis and its relationship to the possible development of secondary oligomenorrhoea and early menopause is discussed.

Naturally occurring genital mycoplasmosis in mice.

The first isolations of Mycoplasma pulmonis were made from inflamed ovaries of 2 C3H/F1 mice. Investigation of cultures from a further 110 apparently healthy mice revealed 14 cases of M. pulmonis localized in the ovaries and associated with oophoritis.

[Species composition of nonpigment-forming bacteroids isolated from the intestines of healthy persons and from clinical material]. / Vidovoi sostav ne obrazuiushchikh pigmenta bakteroidov, vydelennykh iz kishechnika zdorovykh liudei i klinicheskogo materiala.

The comparative study of the specific composition of bacteroids isolated from the intestine of healthy persons and from clinical material obtained from patients with different purulent inflammatory diseases has been carried out. This study has revealed that in the former case the prevalent bacteroid species are B. vulgatus and B. distasonis and in the latter case, B. thetaiotaomicron and B. fragilis.

Bilateral enterobius vermicularis salpingo-oophoritis.

Inflammatory pelvic disease secondary to infection with Enterobius vermicularis is rare in that pinworms are usually asymptomatic inhabitants of the terminal small bowel and cecum. When these parasites do cause symptoms, however, there is a spectrum of gastrointestinal and genitourinary complaints. A case is presented of a woman with bilateral abdominal pain that was found to be due to a combination of parasitic and bacterial (Bacteroides fragilis) infection. The parasitic fallopian tube infection may have predisposed the fallopian tubes to a microbial tuboovarian abscess.