Impact of lipopolysaccharide administration on luteinizing hormone/choriogonadotropin receptor (Lhcgr) expression in mouse ovaries.

Lipopolysaccharide (LPS) is isolated from the genital tract of animals suffering from uterine damage and ovarian dysfunction. This study provides direct molecular evidence about the mechanism through which endotoxins cause reproductive disorders. Granulosa cells and ovaries were collected from immature mice treated with eCG or with eCG and LPS injection intraperitoneally. Normal large antral follicles were observed in ovaries obtained from eCG and LPS coinjected mice, and the morphology of the ovaries was similar to that observed in the control group. These antral follicles were not deemed atretic because few TUNEL-positive cells were observed. However, the granulosa cells of large antral follicles did not acquire the ability to respond to hCG stimulation. The number of ovulated oocytes was significantly lower in LPS-injected mice after superovulation compared to mice that were not exposed to LPS. The low reactivity was caused by the limited expression of the Lhcgr gene, which encodes the LH receptor in granulosa cells as well as an LPS-induced increase in the level of Dnmt1 expression. The methylation rate of the Lhcgr promoter region was significantly higher in granulosa cells obtained from the LPS treatment group compared with the control group. Together, these findings demonstrated that the decrease in the expression of Lhcgr due to LPS was a result of the epigenetic regulatory action of LPS. Our studies suggest that ovarian follicular cysts that is characterized by bacterial infection in humans and animals, is closely connected to the level of methylation of the Lhcgr promoter region.

Assisted Reproductive Technology as a Transcutaneous Route for Bacterial Contamination of Ovarian Endometrioma with Coagulase-Negative Staphylococcus: Case Report and Review of the Literature.

Tubo-ovarian abscess may develop in women with endometrioma following assisted reproductive technology (ART). The infection, though rare, is typically late in onset and may present several months after the procedure, and in pregnancy-with the risks of abortion and premature labor. It is thought that transcutaneous oocyte retrieval during ART is the route for bacterial contamination resulting in infection of the endometrioma. Pathogens reported in the literature include Escherichia coli (E. coli) and Group B streptococcus (GBS) but Staphylococcus lugdunensis (S. lugdunensis), a coagulase-negative staphylococcus (CoNS), and groin and perineal skin commensal was isolated from the endometrioma in this case. We discuss the challenges in diagnosis and treatment of this rare condition and the implications of the discovery that an organism previously dismissed as a contaminant has emerged as a causative organism in severe, deep-seated infections of soft tissues in recent literature.

Tubo-ovarian abscess with endometrial cyst probably infected by Campylobacter fetus: Two cases.

Campylobacter fetus often causes systemic infection in immunocompromised or older patients, and prenatal infection, but Campylobacter has rarely been reported as a cause of adnexitis in healthy young women. Here we report two cases of endometriotic cysts infected by C. fetus for the first time. In case 1, a 28-year-old woman with a left adnexal cyst was hospitalized for left tubo-ovarian abscess and underwent left salpingo-oophorectomy. In case 2, a 22-year-old woman with a right adnexal cyst was hospitalized for a bilateral tubo-ovarian abscess and underwent right salpingo-oophorectomy and left salpingectomy. In both cases, C. fetus was detected on culture, and histopathology indicated a purulent endometriotic cyst. The present findings suggest that endometriotic cyst can be a focus of C. fetus infection.

Streptococcus pneumoniae: the forgotten microorganism in neonatal sepsis.

UNLABELLED: Streptococcus pneumoniae is a rarely cause of neonatal sepsis. Its prevalence is low but with a mortality of 50%. Measures to prevent Streptococcus agalactiae transmission could help to increase Invasive Pneumococcal Disease (IPD) in newborns. Transmission could be from mother intrapartum; or in those cases of late onset sepsis, the community carriers. Systematic vaccination with PCV-7 and PCV-13 has reduced IPD rates. We present a case of a newborn with no perinatal risk factors for infection. In the first 24 hours after surgery of an ovarian cyst, the patient started with bad general condition with fever and regular perfusion. Empiric antibiotic treatment was started. Streptococcus pneumoniae was isolated in blood culture. CONCLUSION: In neonatal sepsis, we always think in Streptococcus agalactiae. Streptococcus pneumoniae is rare but with a high morbidity and mortality. Systematic vaccination is a measure that has demonstrated a reduction in the incidence of Invasive pneumococcal disease.

Salmonella paratyphi A-infected ovarian cyst in returning traveller--an unusual complication of enteric fever.

We report a case of Salmonella paratyphi A enteric fever in a returned New Zealand traveller complicated by an infected ovarian cyst, which resulted in clinical and microbiological relapse despite appropriate antibiotic treatment. Extraintestinal manifestations of enteric fever are infrequent but should be considered in situations where treatment response to first-line antibiotics for adequate duration is suboptimal.

[Fatal Clostridium sordellii infection originated in an ovarian cyst]. / Fatal Clostridium sordellii-infektion udgået fra ovariecyste.

Clostridium sordellii is a Gram-positive bacterium which can cause a serious toxic shock syndrome with a mortality of up to 69%. C. sordellii is a part of the normal vaginal flora in up to 10% of all women. This case describes a fatal case of a healthy 49 year-old woman with a C. sordellii-infection originating from an ovarian cyst. Quick diagnosis is difficult because of the non-specific flu-like symptoms. Survival requires immediate source control and specific antibiotic therapy capable of suppressing toxin production. In rodents superantigen antibodies have shown neutralizing effects.

Abiotrophia/Granulicatella tubo-ovarian abscess in an adolescent virginal female.

Tubo-ovarian abscess (TOA) is a common acute complication of pelvic inflammatory disease (PID). It can also develop as a complication of pelvic or abdominal surgery, malignancy, and intra-abdominal processes such as appendicitis. In premenopausal women, PID is the most common cause of tubo-ovarian abscess. We report a case of tubo-ovarian abscess in a virginal adolescent female with no past surgical history and no known history of appendicitis, inflammatory bowel disease, or cancer. Cultures of the tubo-ovarian abscess drainage grew Abiotrophia/Granulicatella species. This case supports including TOA in the broad differential diagnosis for abdominal pain with fever in adolescent females regardless of sexual history.

Pelvic tuberculosis reactivated by in vitro fertilization egg collection?

OBJECTIVE: To report a case of pelvic tuberculosis, presenting a few months after an unsuccessful IVF cycle. DESIGN: Case report and discussion. SETTING: District General Hospital with National Health Service, United Kingdom. PATIENT(S): A 40-year-old nulliparous woman. INTERVENTION(S): Drainage of the ovarian abscess and biopsy. MAIN OUTCOME MEASURE(S): Histology confirmed the diagnosis of tuberculosis. RESULT(S): Patient has been diagnosed with tuberculosis and is now undergoing treatment. CONCLUSION(S): Although pelvic tuberculosis is rare in the developed world, it should be considered as a differential in the high-risk population.

Cryptococcosis masquerading as a tuboovarian abscess.

This report describes a 25-year-old human immunodeficiency virus- seropositive patient who initially presented with clinical features of a tuboovarian abscess. After a poor response to antibiotic therapy, laparotomy and excision of a right-sided, unilocular, pseudocystic ovarian mass measuring 140 x 80 x 60 mm were undertaken. Mucoid gelatinous material, with a glistening appearance and slimy consistency, coated the inner surface of the thick wall. The cyst contained clear, viscid fluid with a similar slimy consistency. Although the macroscopic diagnosis was that of an ovarian mucinous cystadenocarcinoma, histopathologic assessment confirmed a well-circumscribed pseudocystic cryptococcoma with a wall of granulation and fibrous tissue and compressed ovarian stroma. The inner surface was covered by large, paucireactive, extracellular "yeast lakes" of carminophilous Cryptococcus neoformans yeasts of varying shape and size. To the best of our knowledge, this is the first documentation of ovarian cryptococcosis in the English language literature. Despite their rarity in the female genital tract, fungal infections must be considered in the differential diagnosis of patients presenting with pelvic pain of obscure origin and a pelvic mass that is refractory to antibiotic therapy.

An unusual presentation of actinomycosis in a young woman, after surgery.

Actinomycosis is an unusual, chronic granulomatous disease. Actinomyces israelli has been found to be related to infectious processes in those patients with affected skin integrity leading to abscess formation, fistulae or mass lesions. Actinomycosis mainly presents in three forms cervicofacial (50%), abdominal (20%) and thoracic (15%). Pelvic cases have been rarely reported and are usually associated with the use of intrauterine devices. We describe a case of a 23 y/o female without history of intrauterine device use, who was admitted with an ovarian cyst following an appendectomy. An ovarian abscess was drained. The pathology showed a granuloma and focal sulfur granules like particles compatible with Actinomyces. This is a case of pelvic Actinomyces, not related to the use of an intrauterine device.

An unusual presentation of actinomycosis in a young woman, after surgery

Actinomycosis is an unusual, chronic granulomatous disease. Actinomyces israelli has been found to be related to infectious processes in those patients with affected skin integrity leading to abscess formation, fistulae or mass lesions. Actinomycosis mainly presents in three forms cervicofacial (50%), abdominal (20%) and thoracic (15%). Pelvic cases have been rarely reported and are usually associated with the use of intrauterine devices. We describe a case of a 23 y/o female without history of intrauterine device use, who was admitted with an ovarian cyst following an appendectomy. An ovarian abscess was drained. The pathology showed a granuloma and focal sulfur granules like particles compatible with Actinomyces. This is a case of pelvic Actinomyces, not related to the use of an intrauterine device

Production, reproductive, and metabolic factors associated with chlamydial seropositivity and reproductive tract antigens in dairy herds with fertility disorders.

While chlamydial infections cause abortions in cattle, its role in other reproductive disorders is uncertain. This study identified the risk factors for chlamydial infection in herds with history of subfertility. We investigated the possible effects of coinfections, different metabolic parameters, abortion, ovarian cysts, pathological vaginal discharge, length of the open period, milk yield, housing conditions and age. In cows from 34 farms with elevated reproductive disorders, 41.5% had antibodies against chlamydia, while chlamydia antigen was detected in the vagina and uterus of 46.7%. A statistical relationship between seropositivity and antigen positivity was not found. Abortion (OR = 6.6) and loose housing (OR = 2.3) were risk factors for the presence of chlamydia antibodies. Furthermore, there were significant relationships between metabolic disorders and chlamydial infections. Increased levels of beta-hydroxybutaric acid (OR = 6.8) and hypocalcaemia (OR = 6.0) often accompanied chlamydia antigen in the vagina. Increased age (OR = 1.2) and pathological vaginal discharge (OR = 2.4) were identified as risk factors for chlamydia antigen in the vagina. The largest risk factor was for the association of ovarian cysts (OR = 21.5) with uterine antigen. In conclusion, chlamydial infection in dairy herd cows is best understood as a multifactorial disease.

[Pelvic inflammatory disease-- microbial findings]. / Mikrobni nakhodki pri tazovo-vuzpalitelna bolest.

During the period 1997-2001 in the Microbiological laboratory of University Hospital "Maichin don" 20 women with clinical diagnoses of obs. kysta ovarii, 3 with obs. grav. extrauterina, 9 with pyosalpinx, 37 with TOA, 14 women with pelveoperitonitis were examined. The microbial findings of examined aspirates from CD and materials taken by means of surgical intervention have been presented. The importance of the evaluation of direct microscopical preparation (dmp) from the materials examined fir any existing inflammatory process has been clearly defined. In 14 of the cases (19.1%) in the presence of lot of Leuc in dmp the examined purulent collections didn't show evidence of growth of microorganisms. In the age group 16-25 in 4 of the examined 29 women with acute PID there has been found a positive culture of N. gonorrhoeae. The highest percentage as the cause of TOA and pelveoperitonitis has been attributed to association of microorganisms with anaerobic species having the leading part.

[Evaluation of incidence of Chlamydia trachomatis infections among the group of infertile women diagnosed by laparoscopy, and based on properties of Chlamydia trachomatis in the cervical canal, peritoneal fluid and ovarian cyst puncture]. / Ocena czestosci wystepowania infekcji wywolywanych przez Chlamydia Trachomatis, u nieplodnych kobiet diagnozowanych laparoskopowo, na podstawie obecnosci Chlamydii Trachomatis w szyjce macicy, plynie z wolnej jamy otrzewnowej, punktatów torbieli jajnika.

The number of 75 patients who underwent diagnostic et operative laparoscopy was analysed. The percentage of infection cases caused by Chlamydia Trachomatis was 9.33% investigations proved correlation between fallopian tube factor and infection. It seems that pelvic infection not always undergoes with infection of uterine cervix.

[Secondary infection of the ovarian endometriotic cysts].

OBJECTIVE: To explore the clinic manifestations, diagnostic methods and principles of management in the secondary infection of the endometriotic cysts of ovary. METHODS: Thirteen cases of the infected ovarian endometriotic cysts were analysed retrospectively in our hospital from Jan. 1990 to Dec. 1996. The diagnosis was confirmed by the operation and pathologic findings. RESULTS: The clinic manifestations were divided into five types, namely acute, subacute, chronic, occult and stabile types. The definitive diagnosis can be made by abdominal pain, fever and adnexal mass combined with B-scan findings and chocolate-brown purulent fluid which was punctured from the adnexal mass. Operation was the main method for treatment. CONCLUSIONS: Secondary infection of the endometriotic cyst is one of the gynecologic emergency. Correct diagnosis and prompt management are of vital importance.

Reproductive tract lesions in heifers after intrauterine inoculation with infectious bovine rhinotracheitis virus.

Cross-breed heifers given infectious bovine rhinotracheitis virus by intrauterine inoculation 1 day after natural mating with a noninfected bull were killed on postinoculation days 4 to 14. When reproductive organs were examined for gross and microscopic lesions and for virus infection, the most severe uterine lesions were found in the body and caudal portions of the uterine horns of heifers killed between postinoculation days 4 and 9. Primary pathologic features were necrosis, edema, hemorrhage, and a diffuse accumulation of mononuclear cells, mostly lymphocytes; numerous lymphocytes were in mitosis. In cranial parts of uterine horns, the only lesions observed were a few small lymphocytic foci in the endometrial lamina propria. Lesions were not seen in the oviducts. In many heifers, the ovarian corpus luteum (CL) was cystic. In a few of these heifers, the cyst had a necrotic wall that was bordered by a zone of proliferating mononuclear cells. Focal necrosis and lymphoid proliferation were common in the parenchyma of cystic and noncystic CL. Similar necrotizing lesions were sometimes present in non-CL ovarian tissue. Infectious bovine rhinotracheitis virus was most frequently isolated from the uterine body, the internal os of the cervix, and the CL. Isolations were not made from blood samples taken at the time of necropsy. Isolation of virus from the CL correlated with the detection of luteal inflammation by light microscopy, but did not correlate with the presence of cysts. There also was no correlation between cystic CL and the severity of uterine lesions.