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A tubo-ovarian abscess is a pocket of pus that forms during an infection in a fallopian tube and ovary.

This condition most commonly occurs in women who have infection or inflammation in the reproductive tract (pelvic inflammatory disease). A tubo-ovarian abscess is usually diagnosed based on a physical exam or pelvicultrasound. Some abscesses are found during surgical exploration of the abdomen. Antibiotics are the first-line treatment for a tubo-ovarian abscess. Very large abscesses or abscesses that do not go away after antibiotic treatment can be drained. Draining may be done with a large needle guided by ultrasound or by surgically cutting into the abscess. Sometimes the infected tube and ovary also have to be surgically removed.

What is a tubo-ovarian abscess? A woman with a tubo-ovarian abscess has a collection of pus and bacteria within the part of the fallopian tube that is next to the ovary. A tubo-ovarian abscess is a severe form of pelvic inflammatory disease, which is usually caused by asexually transmitted disease. What are the symptoms of a tubo-ovarian abscess? Symptoms of a tubo-ovarian abscess include lower abdominal pain, low back pain, vaginal discharge, and fever. Additional symptoms may include joint pains,joint swelling, rash, heavy menstrual bleeding and vomiting. How does the doctor treat a tubo-ovarian abscess? Treatment for a tubo-ovarian abscess includes antibiotics and nonsteroidal anti-inflammatory medications for pain. Treatment for a severe tubo-ovarian abscessmay require narcotic pain medication and surgery. Male sexual partners should be evaluated by a doctor.

Risk factors for a tubo-ovarian abscess include:


Intrauterine device Multiple sexual partners History of pelvic inflammatory disease Unprotected sex: not using condoms Sexual partner with sexually transmitted disease Sexual activity during adolescence Any condition that causes a weakening of the immune system such as:

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Diabetes Organ transplant Chemotherapy AIDS

Symptoms of a tubo-ovarian abscess include:


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Abdominal pain: Lower abdominal pain: Left lower abdominal pain Right lower abdominal pain Abdominal pain worsens with activity Abdominal pain may worsen during intercourse Back pain: Lower back pain Vaginal discharge Fever Chills Joint pains Joint swelling Rash Heavy menstrual bleeding Vaginal spotting Nausea Vomiting Fatigue Malaise

The evaluation of pelvic inflammatory disease and tubo-ovarian abscess begins with a history and physical exam, including a pelvic exam. Physical findings in someone with a tubo-ovarian abscess may include:

Lower abdominal tenderness Tenderness during pelvic examination Vaginal discharge Pus draining from the cervix Fever Rash

Tests are necessary to make the diagnosis of tubo-ovarian abscess. Tests that may be used to evaluate tubo-ovarian abscess include:

VDRL blood test Complete blood count Chlamydia culture Gonorrhea culture Pelvic ultrasound PAP smear Pregnancy test

Imaging tests that may be used to evaluate tubo-ovarian abscess include:


Pelvic ultrasound CT scan of the pelvis MRI scan of the abdomen

Treatment for a tubo-ovarian abscess includes antibiotics and nonsteroidal anti-inflammatory medications for pain. Treatment for a severe tubo-ovarian abscessmay require narcotic pain medication and surgery. Drainage of the abscess may be accomplished laparoscopically. Male sexual partners should also be evaluated by a doctor to avoid re-infection. Specific treatment for a tubo-ovarian abscess includes:
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Antibiotics for a tubo-ovarian abscess: Selection depends on the bacteria causing the infection. Cefoxitin (Mefoxin) Cefotetan (Cefotan) Doxycycline (Vibramycin) Clindamycin (Cleocin)

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Metronidazole (Flagyl) Gentamicin (Gentacidin, Garamycin) Avoid intercourse until after antibiotic treatment is completed. Sexual partners should be evaluated by a doctor: Re-infection is quite common if sexual partners are not treated. Nonsteroidal anti-inflammatory medications for pain: Ibuprofen (Motrin) Naproxen (Anaprox, Naprosyn) Ketoprofen (Orudis) Narcotic pain medication: For moderate to severe pain For short term use only Surgery for tubo-ovarian abscess: Using laparoscopy

A tuboovarian abscess is an inflammatory mass involving the fallopian tube, ovary, and, occasionally, other adjacent pelvic organs (eg, bowel, bladder) [1]. This may manifest as a tuboovarian complex (an agglutination of those structures) or a collection of pus (tuboovarian abscess). These abscesses are found most commonly in reproductive age women and typically result from upper genital tract infection. Tuboovarian abscess is usually a complication of pelvic inflammatory disease. Tuboovarian abscess is a serious and potentially life-threatening condition. Aggressive medical and/or surgical therapy is required and rupture of an abscess may result in sepsis. The mortality rate associated with tuboovarian abscess was approximately 50 percent or higher prior to the advent of broad-spectrum antibiotics and modern surgical practice [2,3]. In current practice, the mortality rate approaches zero for abscesses that have not ruptured. Current mortality rates for patients with ruptured abscesses are not reported in the literature; data from the 1960s suggested a mortality rate ranging from 1.7 to 3.7 percent [2,4,5]. Treatment modalities include broad spectrum antibiotic therapy, minimally-invasive drainage procedures, invasive surgery, or combinations of these interventions. For the large majority of small to medium sized tuboovarian abscesses, antibiotic therapy alone can affect cure