Tubo-ovarian abscess

Editor-In-Chief: Prab R Tumpati, MD
Obesity, Sleep & Internal medicine
Founder, WikiMD Wellnesspedia &
W8MD's medical weight loss NYC, sleep center NYC
Philadelphia medical weight loss and Philadelphia sleep clinics

Tubo-ovarian abscess
Diagram showing sites of tubo-ovarian abscess
Synonyms	TOA
Pronounce	N/A
Specialty	N/A
Symptoms	Pelvic pain, fever, vaginal discharge, nausea, vomiting
Complications	Sepsis, infertility, chronic pelvic pain
Onset	Sudden or gradual
Duration	Varies
Types	N/A
Causes	Pelvic inflammatory disease, sexually transmitted infections
Risks	Multiple sexual partners, intrauterine device use, previous pelvic inflammatory disease
Diagnosis	Pelvic ultrasound, CT scan, MRI, laparoscopy
Differential diagnosis	Ectopic pregnancy, appendicitis, ovarian torsion
Prevention	N/A
Treatment	Antibiotics, surgery
Medication	Cefoxitin, doxycycline, metronidazole
Prognosis	Good with treatment, risk of complications if untreated
Frequency	Common in reproductive-age women
Deaths	N/A

A collection of pus in the fallopian tube and ovary

Bacteroides fragilis under Gram stain

Tubo-ovarian abscess

A tubo-ovarian abscess (TOA) is a type of pelvic inflammatory disease (PID) characterized by a collection of pus that involves a fallopian tube and ovary. It is a serious condition that can lead to severe complications if not treated promptly.

Causes

Tubo-ovarian abscesses are often caused by bacterial infections. The most common bacteria involved are those associated with sexually transmitted infections (STIs), such as Neisseria gonorrhoeae and Chlamydia trachomatis. Other bacteria, including anaerobic bacteria like Bacteroides fragilis, can also be involved.

Bacteroides fragilis, a common anaerobic bacterium involved in TOA

Symptoms

The symptoms of a tubo-ovarian abscess can include severe pelvic pain, fever, vaginal discharge, and nausea. Some women may also experience irregular menstrual bleeding or pain during intercourse.

Diagnosis

Diagnosis of a tubo-ovarian abscess typically involves a combination of clinical examination, ultrasound imaging, and sometimes CT scans or MRI. Blood tests may show elevated white blood cell counts and markers of inflammation.

Diagram showing sites of tubo-ovarian abscess

Treatment

Treatment usually involves antibiotic therapy to address the underlying infection. In some cases, surgical intervention may be necessary to drain the abscess. This can be done through laparoscopy or laparotomy.

Complications

If left untreated, a tubo-ovarian abscess can lead to serious complications such as sepsis, infertility, or chronic pelvic pain. It is crucial to seek medical attention if symptoms suggestive of TOA occur.

Prevention

Preventive measures include practicing safe sex, regular screening for STIs, and prompt treatment of any pelvic infections to prevent progression to TOA.

See also

• Pelvic inflammatory disease
• Ovarian cyst
• Endometriosis