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- Tubo-ovarian abscess refers to an infection in either the ovaries (source of eggs) or the fallopian tubes (which deliver eggs to the uterus). This results in a collection of pus, causing symptoms of Pelvic Inflammatory Disease or stomach pain.
- The infection is usually accompanied by fever, and the patient will appear ill. Treatment is generally with antibiotics. In some, surgery may be required to remove the pus.
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- The most common symptoms include vaginal discharge along with vaginal pain, itching, or burning.
- The infection causing the abscess
may come from various sources. The following are most
common:
- Candidal infections cause itching and burning. There is a thick, white discharge that usually does not smell bad. This type of infection occurs more often in women with diabetes, women who are pregnant, and in women taking antibiotics.
- Trichomonas causes vaginal itching. Usually, there is a green colored, frothy discharge that smells bad. This infection usually spreads through sexual contact.
- Bacterial vaginosis usually causes a grayish discharge that often smells bad. It may cause a fish-like odor.
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- Tubo-ovarian abscesses are usually due to an infection that travels up the woman's genital tract.
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- A physical examination (including a
pelvic exam) is the first step in making the diagnosis. It may show inflammation/irritation of the vagina and the presence of discharge. The examination of the uterus or ovarian regions may be abnormal.
- During the pelvic exam, a sample of the discharge is taken and either sent to the lab or examined by the doctor under a microscope. This is usually enough to make the diagnosis.
- Ultrasonography shows a multilocular, cystic, complex adnexal mass, often with debris and thick septations.
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- Treatment depends on the type of infection present.
- For Candida infections (the common
yeast infection) there are several options:
- Miconazole , clotrimazole , or butoconazole (2% cream) can be used for 3 days.
- Clotrimazole or miconazole (2% cream) can be used for 7 days.
- A one-time dose of clotrimazole or a one time oral dose of fluconazole may also be used.
- If the infection keeps coming back, treat with ketoconazole for 6 months.
- Trichomonas vaginalis can be treated with metronidazole. Sexual partners also need to be treated because it is spread by sexual contact.
- Bacterial vaginosis can be treated in several was:
- Metronidazole
- Clindamycin vaginal cream once a day for 7 days, or clindamycin by mouth for 7 days
- Metronidazole vaginal gel twice a day for 5 days.
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