Enterobius vermicularis in tubo-ovarian abscess: A rare and interesting incidental finding - A case Report.

Enterobius vermicularis is a common intestinal nematode; however, rare extraintestinal Enterobius infections have been reported from different parts of the world. Here, we present a case of tubo-ovarian abscess in an otherwise healthy young sexually active female with no known comorbids with history of on and off lower abdominal pain for one year and high grade fever for one month. On the basis of further workup and radiological evaluation, a preoperative diagnosis of right sided tubo-ovarian abscess was made and salpingo-oophorectomy was performed laproscopically in July 2015. Histopathology of the resected tissue revealed necrosis and in one area Enterobius vermicularis was identified surrounded by neutrophils and eosinophil rich abscess. A final diagnosis of severe acute and chronic salpingo-oophoritis with abscess formation, secondary to Enterobius vermicularis was made. Signs and symptoms of parasitic involvement in tubo-ovarian abscesses are not much different than usual presentations of pelvic inflammatory diseases and identification of a parasite in a tubo-ovarian tissue sample is a rare clinical finding. A high index of suspicion on the part of histopathologist as well as clinician is important for timely diagnosis and effective management of such cases.

Enterobius Vermicularis-Associated Pelvic Inflammatory Disease in a Child.

BACKGROUND: Enterobius vermicularis is the most highly prevalent intestinal worm in childhood and is generally considered of low pathogenicity. Little is known about the inflammatory complications of the female genital tract induced by E. vermicularis in childhood. CASE: A case of E. vermicularis-associated pelvic inflammatory disease with right salpingitis mimicking acute abdomen due to appendicitis in an 11-year-old girl is presented. CONCLUSION: E. vermicularis-related pelvic inflammatory disease should be included in the differential diagnosis of abdominal pain in children. Increased awareness is necessary to avoid an unnecessary surgery and to choose the correct antibiotic treatment.

Trichomonas vaginalis is associated with pelvic inflammatory disease in women infected with human immunodeficiency virus.

We assessed the association between the causative agents of vaginal discharge and pelvic inflammatory disease (PID) among women attending a rural sexually transmitted disease clinic in South Africa; the role played by coinfection with human immunodeficiency virus type 1 (HIV-1) was studied. Vaginal and cervical specimens were obtained to detect Neisseria gonorrhoeae, Chlamydia trachomatis, Trichomonas vaginalis, and bacterial vaginosis. HIV-1 infection was established by use of serum antibody tests. A total of 696 women with vaginal discharge were recruited, 119 of whom had clinical PID. Patients with trichomoniasis had a significantly higher risk of PID than did women without trichomoniasis (P=.03). PID was not associated with any of the other pathogens. When the patients were stratified according to HIV-1 status, the risk of PID in HIV-1-infected patients with T. vaginalis increased significantly (P=.002); no association was found in patients without HIV-1. T. vaginalis infection of the lower genital tract is associated with a clinical diagnosis of PID in HIV-1-infected women.

[Parasitic diseases are a risk factor of inflammations of the small pelvis organs. Trichomoniasis]. / Parazitozy--faktor riska vospalitel'nykh zabolevanii organov malogo taza. Trikhomoniaz.

Clinical and laboratory studies were made in 2259 persons by using serological assays, including cultural and bacterioscopic assays in 1824 and 363 persons, respectively, in order to indicate Trichomonas infection among men, women, and 2-15-year-old children who had chronic inflammation of the urogenital system, as well as among children aged 2 months to 16 years who had a severe somatic disease. Parasitic cenoses of the urogenital tract were studied in women with trichomoniasis and reproductive dysfunction. Trichomonas invasion is an etiological factor of inflammatory small pelvic diseases, chronic prostatitis, reproductive dysfunction in males and females. Furthermore, trichomoniasis is an essential factor, that predisposes to recurrent viral infections: genital herpes and pointed condyloma, and substantially increases the risk of birth of babies with clinical manifestations of intrauterine infection. According to the studies, a laboratory diagnosis of trichomoniasis should be made by cultural assay due to the low sensitivity of bacterioscopy by sampling a biological material from females in the periovulatory period that corresponds to the hyperestrogenicity, which substantially increases the number of isolated cultures and characterizes the depth of integration of metabolic processes of a parasite and its host.

The associations between pelvic inflammatory disease, Trichomonas vaginalis infection, and positive herpes simplex virus type 2 serology.

OBJECTIVE: Roles for Chlamydia trachomatis and Neisseria gonorrhoeae infections in pelvic inflammatory disease pathogenesis are well delineated; however, the etiologic contributions of herpes simplex virus type 2 (HSV-2) and Trichomonas vaginalis have been underexplored. GOAL: The goal of this study was to investigate the association between acute and plasma cell endometritis, fallopian tube obstruction, HSV-2 serology, and T. vaginalis infection. STUDY DESIGN: The authors conducted a cross-sectional secondary analysis of 736 women at risk for bacterial sexually transmitted diseases that used endometrial biopsy data obtained at enrollment as well as hysterosalpingography results obtained 12 weeks after enrollment. RESULTS: Women diagnosed with T. vaginalis at enrollment were more likely to have histologic evidence of acute endometritis. Both plasma cell and acute endometritis were significantly more common among women with positive serology HSV-2; furthermore, women coinfected with HSV-2 and C. trachomatis, N. gonorrhoeae, T. vaginalis, or bacterial vaginosis were much more likely to be diagnosed with acute endometritis than were women infected with HSV-2 or one of these pathogens alone. Among women with available HSV-2 serology and hysterosalpingogram results, HSV-2 was the only genital tract pathogen infection associated with fallopian tube obstruction. CONCLUSIONS: Our analyses demonstrate that T. vaginalis infection and positive HSV-2 serology are associated with endometritis. Further work will be needed to determine the specific roles these pathogens may play in pelvic inflammatory disease pathogenesis.

[Prevention and epidemiology of trichomonal vaginitis in women treated in gynecological departments]. / Profilaktyka i epidemiologia rzesistkowicy pochwy kobiet leczonych w oddzialach ginekologicznych.

The purpose of the work is to present the results of prophylactic actions used in the Departments of the Institute of Obstetrics and Gynecology of the Medical Academy in Bia l ystok giving reasons for changes and modifications concerning the present state of procedures. At the same time, attention has been paid to some epidemiological factors of trichomoniasis in women treated in gynecological departments for various diseases of the female genital organ. Women treated in the Departments of the Institute of Obstetrics and Gynecology in 1974-1975 were included in these studies. Total number of the investigated women was 9000 but those with trichomoniasis were 610. There were presented the results of procedures at the admittance rooms of the Gynecological Departments in which examinations and treatment of trichomoniasis, in reasonable cases, were carried out before admitting the patients to proper gynecological treatment were presented. The whole of the evaluation was based on our own scheme of microbiological procedures.

Pelvic inflammatory disease associated with Enterobius vermicularis.

A case of pelvic inflammatory disease in a sexually non-active 13 year old girl is described, with evidence of pinworms as the cause. Albendazole treatment cleared the infestation but the patient suffered subsequent bouts of lower abdominal pain. The literature is reviewed regarding abdominal pathology associated with ectopic migration of pinworms.

Sexually transmitted pathogens in acute pelvic inflammatory disease.

The prevalence of sexually transmitted pathogens in two groups of women was studied: 50 women with clinical diagnoses of acute pelvic inflammatory disease (PID) and 50 asymptomatic women attending a family planning clinic (FPC). Genital specimens, collected by non-invasive procedures, were examined. Endocervical Neisseria gonorrhoeae was present in 62% of the PID group and 10% of the FPC group (P less than 0.0001). One-third of N. gonorrhoeae isolates were penicillinase-producing strains. Chlamydia trachomatis was isolated from the endocervix in 30% of the PID group and 26% of the FPC group (P = 0.8240 NS). Mycoplasma hominis was more prevalent in the vaginas and endocervices of the PID group than the FPC group (84% and 72% v. 50% and 42%; P = 0.0006 and 0.0047 respectively). Trichomonas vaginalis was present in 56% of the PID group and 20% of the FPC group (P = 0.0004). Syphilis serology was positive in 34% of the PID group and 10% of the FPC group (P = 0.0026). In the PID group of patients, 8% were positive for HBsAg. Antibody to the human immunodeficiency virus was not detected in any of the 100 women. The high prevalence of recognised sexually transmitted pathogens underlines the need for appropriate antimicrobial agent(s) active against N. gonorrhoeae, C. trachomatis and M. hominis in patients with PID. In view of the high prevalence of penicillinase-producing strains of N. gonorrhoeae, routine use of an antibiotic active against such strains is desirable.

Schistosoma mansoni pseudo-cyst as a cause of chronic pelvic pain.

A case of mansoni schistosomiasis causing peritoneal inflammation and chronic iliac pain is reported. The patient complained of iliac pain for 6 months. Physical examination and sonographic evaluation found a tumor in the left iliac fosse. A pseudocyst was removed from the pelvic region. The histopathology confirmed the diagnosis of S. mansoni. This is a rare case of S. mansoni in the pelvic cavity.

[A case of pelvic paragonimiasis combined with myoma uteri and pelvic inflammatory disease].

Paragonimus westermani is a lung fluke of humans that is usually found in the lungs but may be found elsewhere in many unusual locations. A case of pelvic paragonimiasis was found incidentally by surgical intervention of inflammatory disease and myoma uteri. She was a 51-year-old Korean woman complaining of lower abdominal pain and intermittent vaginal spotting. Numerous Paragonimus ova were observed in the resected omentum in the pelvis after total abdominal hysterectomy. It is suggested that pelvic paragonimiasis may be one of causative agents of pelvic inflammatory disease.