Ovarian Endometrioma Superinfected With Salmonella: Case Report and Review of the Literature

Adelman, Max W.; Johnson, Joseph E.; Hohmann, Elizabeth L.; Gandhi, Rajesh T.

doi:10.1093/ofid/ofx048

Cited by 9 publications

(7 citation statements)

References 32 publications

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“…This route of infection is also likely in our patient, where a paraovarian cyst was infected and the adjacent fallopian tubes did not show evidence of inflammation. A review of 33 cases of Salmonella ovarian abscesses revealed that in 79%, blood cultures were sterile, as in our case [6].…”

Section: Discussionsupporting

confidence: 57%

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Non Typhoidal Salmonella Suppuration of Ovarian Cyst with Sclerosing Peritonitis: An old disease, A New Face

Rajan¹,

Sagili²,

Durairaj³

et al. 2020

SCR

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Invasive non-typhoidal Salmonella is an emerging problem in developing regions like Africa and Asia. Infection of ovarian cysts by typhoid bacilli is a complication dating to the 1800s and is rare in the postantibiotic era. A diabetic, hypertensive post-menopausal lady, our patient presented with a large paraovarian cyst infected the Salmonella group B bacillus. The infection is likely transmitted hematogenously or by the surrounding adherent bowel and omentum. Interestingly, our patient developed sclerosing peritonitis and osseous metaplasia of the rectus sheath as well, possibly a peritoneal inflammation to a disseminated infection. Compounded by her diabetes, the ossified rectus healed poorly, leading to burst abdomen in the post-operative period. Hence, our patient presented with a rare manifestation of an emerging disease. A depressed immune status, influenced by her comorbidities, and the lack of sanitation in pockets of South Asia may have led to a reappearance of these once historic complications of typhoid.

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Section: Discussionsupporting

confidence: 57%

“…There have been several reports of infection of ovarian cysts by Salmonella [5][6][7][8][9][10][11][12]. Focal metastatic Salmonella infections are seen in almost every site in the body, attracted by a pre-existent ovarian lesion, or simply by the immunologically privileged ovary.…”

Section: Discussionmentioning

confidence: 99%

Non Typhoidal Salmonella Suppuration of Ovarian Cyst with Sclerosing Peritonitis: An old disease, A New Face

Rajan¹,

Sagili²,

Durairaj³

et al. 2020

SCR

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“…A total of 30,060 AMR bacterial isolates associated with 17,470 instances of planned international travel (at least one AMR organism documented per instance) was documented in the 238 studies [ 27 , 29 , 30 , 31 , 32 , 33 , 35 , 36 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 67 , 68 , 69 , 70 , 71 , 72 , 73 , 74 , 75 , 76 , 77 , 78 , 79 , 80 , 81 , 82 , …”

Section: Resultsmentioning

confidence: 99%

Travel-Related Antimicrobial Resistance: A Systematic Review

et al. 2021

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There is increasing evidence that human movement facilitates the global spread of resistant bacteria and antimicrobial resistance (AMR) genes. We systematically reviewed the literature on the impact of travel on the dissemination of AMR. We searched the databases Medline, EMBASE and SCOPUS from database inception until the end of June 2019. Of the 3052 titles identified, 2253 articles passed the initial screening, of which 238 met the inclusion criteria. The studies covered 30,060 drug-resistant isolates from 26 identified bacterial species. Most were enteric, accounting for 65% of the identified species and 92% of all documented isolates. High-income countries were more likely to be recipient nations for AMR originating from middle- and low-income countries. The most common origin of travellers with resistant bacteria was Asia, covering 36% of the total isolates. Beta-lactams and quinolones were the most documented drug-resistant organisms, accounting for 35% and 31% of the overall drug resistance, respectively. Medical tourism was twice as likely to be associated with multidrug-resistant organisms than general travel. International travel is a vehicle for the transmission of antimicrobial resistance globally. Health systems should identify recent travellers to ensure that adequate precautions are taken.

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“…As a result, vaginal flora, including anaerobic organisms, Gardnerella vaginalis and Mycoplasma hominis and genitalium can cause various gynecological lesions such as endometritis, salpingitis oophoritis, or abscesses [ 14 ]. In the international literature, there have been reported some clinical cases with infected endometriotic cysts that had a medical history of previous infections, such as gastrointestinal infection due to Helicobacter cinaedi or Salmonella [ 15 , 16 ] and genital tract infections [ 17 ]. These examples support a theory that ovarian abscesses in endometriomas can be caused by the hematogenous or lymphatic spread of bacteria [ 18 ].…”

Section: Discussionmentioning

confidence: 99%

Acute Diffuse Peritonitis Due to Spontaneous Rupture of an Infected Endometrioma: A Case Report

Petruškevičiūtė

Bužinskienė

2021

AML

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Background. Endometriosis is defined as a chronic, inflammatory, estrogen-dependent gynaecologic disease. It affects approximately 5–10% of reproductive-age women worldwide. Ovarian endometriosis is the most frequent form of this condition. Endometriotic cysts are found in about 17–44% of women diagnosed with endometriosis. It is well known, that ovarian endometriomas can cause infertility and chronic pelvic pain. Enlarging cysts can also cause ovarian torsion. In addition, ovarian endometriosis slightly increases the risk for ovarian cancer. The rupture of endometriotic ovarian cysts is an exceptional complication. According to the literature, the prevalence is less than 3% among women with endometriosis. The rupture of an ovarian endometrioma can cause acute peritonitis, which can lead to sepsis, septic shock and can be lethal. The occurrence of abscesses within an ovarian endometrioma is an extremely rare complication. Generally, the origin of infected endometriotic ovarian cysts is related to the previous invasive procedures involving pelvic organs or the use of intrauterine devices. Also, ovarian abscesses can be caused by the hematogenous or lymphatic spread of bacteria. Although, the literature points out that infection of endometriotic ovarian cysts can develop spontaneously. In these rare cases, reservoir and route of infection remains an enigma.Case report. A 49-year-old female was brought to the emergency room with severe generalized lower abdominal pain (6/10) and three days lasting fever. Abdominal examination revealed diffuse abdominal pain with anterior abdominal wall muscle tension. Painful solid masses were felt on both sides of the uterus during the pelvic examination. Cystic masses were detected in both ovaries during transvaginal sonography. Computer tomography (CT) of the abdomen and pelvis revealed abnormal changes in both ovaries. A small amount of free fluid was found in the pelvic cavity along with thickened pelvic peritoneum. Suspecting acute peritonitis and bilateral tubo-ovarian abscesses, surgical treatment was performed. Lower midline laparotomy with bilateral adnexectomy and abdominal lavage with 4000 ml normal saline were done. The outcome of peritonitis was evaluated using the Mannheim peritonitis index (MPI=17 – low risk of morbidity and mortality). The histopathological examination revealed the diagnosis of bilateral endometriotic cysts complicated with acute inflammation, with associated acute inflammation of both fallopian tubes. Microbiological cultures from the purulent fluid were negative.Conclusions. Although the occurrence of abscesses within an ovarian endometrioma is an extremely rare finding in clinical practice, it has to be considered by gynaecologists because it might result in a surgical emergency that can be life-threatening. Being aware of the risk factors of abscesses within an endometrioma can lead to an early diagnosis of this rare condition and help to avoid serious complications.

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Ovarian Endometrioma Superinfected With Salmonella: Case Report and Review of the Literature

Cited by 9 publications

References 32 publications

Non Typhoidal Salmonella Suppuration of Ovarian Cyst with Sclerosing Peritonitis: An old disease, A New Face

Non Typhoidal Salmonella Suppuration of Ovarian Cyst with Sclerosing Peritonitis: An old disease, A New Face

Travel-Related Antimicrobial Resistance: A Systematic Review

Acute Diffuse Peritonitis Due to Spontaneous Rupture of an Infected Endometrioma: A Case Report

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