What is tubo-ovarian abscess?

A tubo-ovarian abscess is a pocket of pus that forms because of an infection in a fallopian tube and ovary. A tubo-ovarian abscess is most often caused by pelvic inflammatory disease (PID).

What bacteria causes tubo-ovarian abscess?

They tend to be polymicrobial infections with both aerobic and anaerobic bacteria. The most common organisms include Escherichia coli, Streptococci, Bacteroides fragilis, and Prevotella. Intrauterine devices are associated with Actinomyces israelli.

How is a tubo-ovarian abscess formed?

These abscesses are found most commonly in reproductive age women and typically result from upper genital tract infection. It is an inflammatory mass involving the fallopian tube, ovary and, occasionally, other adjacent pelvic organs. A TOA can also develop as a complication of a hysterectomy.

How do you treat TOA?

Treatment modalities for TOA include antibiotic therapy, minimally invasive drainage procedures, invasive surgery, or a combination of these interventions. The large majority of small abscesses (<7 cm in diameter) resolves with antibiotic therapy alone. The management of TOA is reviewed here.

What is considered a large tubo-ovarian abscess?

32 suggested that an abscess larger than 8 cm requires surgical intervention and is associated with a longer hospital stay and an increase in complications. In addition to initial antibiotic therapy, it is vital to consider acute care of the woman with a TOA.

What are the symptoms of a pelvic abscess?

You may have:

• Swollen belly.
• Diarrhea.
• Fever or chills.
• Lack of appetite and possible weight loss.
• Nausea or vomiting.
• Weakness.
• Cough.

Can tubo-ovarian abscess reoccur?

Tubo-ovarian abscesses are often polymicrobial and typically contain a predominance of anaerobic bacteria.

Is ovarian abscess curable?

Abscesses. PID can sometimes cause collections of infected fluid called abscesses to develop, most commonly in the fallopian tubes and ovaries. Abscesses may be treated with antibiotics, but sometimes laparoscopic surgery (keyhole surgery) may be needed to drain the fluid away.

What is considered a large tubo ovarian abscess?

How is tubo-ovarian abscess diagnosed?

A TOA can be diagnosed by ultrasound, appearing as a complex solid/cystic mass. This can be unilateral or bilateral. A pyosalpinx may be seen as an elongated, dilated, fluid-filled mass with partial septae and thick walls. Incomplete septae within the tubes is a sensitive sign of tubal inflammation or an abscess.

Can an ovarian cyst turn into an abscess?

Infected Ovarian Cyst Cysts can develop in response to a pelvic infection (called an abscess). If an infected cyst ruptures, it can trigger sepsis, a life-threatening immune response to harmful bacteria.

How do you treat pelvic abscess?

Patients with pelvic abscesses are frequently given a triple antibiotic regimen including clindamycin, gentamicin, and aqueous penicillin.

What are the symptoms of a tubo ovarian abscess?

Introduction A tubo-ovarian abscess (TOA) is a complex infectious mass of the adnexa that forms as a sequela of pelvic inflammatory disease. Classically, a TOA manifests with an adnexal mass, fever, elevated white blood cell count, lower abdominal-pelvic pain, and/or vaginal discharge; however, presentations of this disease can be highly variable.

What are the symptoms of a Toa abscess?

Classically, a TOA manifests with an adnexal mass, fever, elevated white blood cell count, lower abdominal-pelvic pain, and/or vaginal discharge; however, presentations of this disease can be highly variable.

What kind of surgery is needed for tubo ovarian abscess?

Treatment / Management Historically, TOAs were treated with a total abdominal hysterectomy and bilateral salpingo-oophorectomy.  Management has changed drastically with the advent of broad-spectrum antibiotics, improved imaging, and drainage techniques.

What is the differential diagnosis for an ovarian abscess?

The differential diagnosis for TOA often includes appendicitis, diverticulitis, inflammatory bowel disease, PID, ovarian torsion, ectopic pregnancy, ruptured ovarian cyst, pyelonephritis, and cystitis. Epidemiology These abscesses most commonly are found in reproductive-age women after an upper genital tract infection.