Emergency surgery for tubo-ovarian abscess identified extended-spectrum beta-lactamase-producing Escherichia coli: the first case presentation revealing causative bacteria

Abstract

We report herein a 41-year-old female with a tubo-ovarian abscess (TOA), which microbial cultures showed to contain extended-spectrum beta-lactamase (ESBL)-producing E. coli, a causative agent of community-acquired infection. The patient initially presented with acute abdominal pain and back pain. Pelvic computed tomography and transvaginal ultrasonography revealed multiple cystic lesions in the bilateral ovaries that suggested TOA. An emergency laparotomy was therefore performed due to the potential for life-threatening septic shock from the TOA-associated pelvic inflammatory disease. Microbial cultures of postoperative fluid discharge from the placed intra-abdominal catheter, vaginal secretions, urine, blood, and feces detected ESBL-producing E.coli. In summary, we successfully performed emergency surgery for life-threatening septic TOA caused by ESBL-producing E. coli infection.

Ovarian Abscess: A Rare but Serious Complication of Transvaginal Oocyte Retrieval for IVF - A Case Report

“…However if there is no response to antibiotics within 72 hours,ultrasound guided aspiration or immediate laparoscopy or laparotomy to be done for abscess drainage. [2] In our case, transvaginal ultrasound guided aspiration of ovarian follicular abscess combined with parenteral antibiotics was done. Various studies have shown that ultrasound guided abscess aspiration is also an safe and effective regimen in hemodynamically stable patient.…”

“…[1] An ovarian abscess is a rare surgical emergency that can be lethal at times. [2] In order to have clinical suspicion of this complication during the process of IVF we are sharing this case of ovarian abscess following oocyte retrieval for IVF. As use of IVF technique is rapidly increasing so are the possible complications.…”

Hydronephrosis Due to Bilateral Tubo-ovarian Abscess

“…Surgical intervention may be considered if it is a recurrence, nonresponsive to antibiotics, or if rupture occurs. 1,3 Minimally invasive measures should be considered, especially in women of childbearing age, to avoid causing infertility. 3 Our patient was prescribed meropenem and she was admitted for care by her obstetrician-gynecologist.…”

Pneumoperitoneum caused by tubo-ovarian abscess in an elderly patient

“…Initial management of TOA is antibiotic therapy, however, if there is not clinical improvement within 2–3 days, surgical intervention should be considered. An indication for immediate operation is the suspicion of rupture TOA or patients potentially developing septic shock [ 5 , 6 ].…”