Abstract
Objective: The purpose of this retrospective study was to compare the clinical outcome and characteristics of pelvic inflammatory disease (PID) complicated by tubo-ovarian abscess (TOA) with PID without TOA.
Methods: Chart reviews were performed for all PID admissions to the University of Medicine and Dentistry of New Jersey-University Hospital, Newark, NJ, from January 1, 1992, to December 31, 1993.
Results: The incidence in this study of TOA based on sonographic evidence of a complex adnexal mass was 18%. The major differences between the patients with and without TOAs were 1) history of hospitalization for PID: 68% (13/19) vs. 29% (25/85); 2) increased erythrocyte sedimentation rate: 82 vs. 41 mm/h; 3) increased WBC count on admission: 16,200 vs. 14,700/ml; 4) failure to respond to initial antibiotic therapy; and 5) longer hospital stay: 7.8 vs. 4.4 days, respectively. Surgical intervention was required in 3 patients: 2 patients who had TOAs and 1 patient who did not have a TOA by clinical examination or by ultrasound.
Conclusions: Despite longer hospital stays and blood tests suggesting more severe disease processes, PID complicated by TOA is usually responsive to intravenous (IV) antibiotic therapy without the need for surgical intervention.
Full Text
The Full Text of this article is available as a PDF (383.9 KB).
Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Benigno B. B. Medical and surgical management of the pelvic abscess. Clin Obstet Gynecol. 1981 Dec;24(4):1187–1197. doi: 10.1097/00003081-198112000-00016. [DOI] [PubMed] [Google Scholar]
- Carney F. E., Jr, Taylor-Robinson D. Growth and effect of Neisseria gonorrhoeae in organ cultures. Br J Vener Dis. 1973 Oct;49(5):435–440. doi: 10.1136/sti.49.5.435. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Franklin E. W., 3rd, Hevron J. E., Jr, Thompson J. D. Management of the pelvic abscess. Clin Obstet Gynecol. 1973 Jun;16(2):66–79. doi: 10.1097/00003081-197306000-00006. [DOI] [PubMed] [Google Scholar]
- Gregg C. R., Melly M. A., McGee Z. A. Gonococcal lipopolysaccharide: a toxin for human fallopian tube mucosa. Am J Obstet Gynecol. 1980 Dec 1;138(7 Pt 2):981–984. doi: 10.1016/0002-9378(80)91092-3. [DOI] [PubMed] [Google Scholar]
- Hager W. D., Eschenbach D. A., Spence M. R., Sweet R. L. Criteria for diagnosis and grading of salpingitis. Obstet Gynecol. 1983 Jan;61(1):113–114. [PubMed] [Google Scholar]
- Hoegsberg B., Abulafia O., Sedlis A., Feldman J., DesJalais D., Landesman S., Minkoff H. Sexually transmitted diseases and human immunodeficiency virus infection among women with pelvic inflammatory disease. Am J Obstet Gynecol. 1990 Oct;163(4 Pt 1):1135–1139. doi: 10.1016/0002-9378(90)90671-s. [DOI] [PubMed] [Google Scholar]
- Kaplan A. L., Jacobs W. M., Ehresman J. B. Aggressive management of pelvic abscess. Am J Obstet Gynecol. 1967 Jun 15;98(4):482–487. doi: 10.1016/0002-9378(67)90100-7. [DOI] [PubMed] [Google Scholar]
- Landers D. V., Sweet R. L. Current trends in the diagnosis and treatment of tuboovarian abscess. Am J Obstet Gynecol. 1985 Apr 15;151(8):1098–1110. doi: 10.1016/0002-9378(85)90392-8. [DOI] [PubMed] [Google Scholar]
- Landers D. V., Sweet R. L. Tubo-ovarian abscess: contemporary approach to management. Rev Infect Dis. 1983 Sep-Oct;5(5):876–884. doi: 10.1093/clinids/5.5.876. [DOI] [PubMed] [Google Scholar]
- Safrin S., Dattel B. J., Hauer L., Sweet R. L. Seroprevalence and epidemiologic correlates of human immunodeficiency virus infection in women with acute pelvic inflammatory disease. Obstet Gynecol. 1990 Apr;75(4):666–670. [PubMed] [Google Scholar]
- Ward M. E., Watt P. J., Robertson J. N. The human fallopian tube: a laboratory model for gonococcal infection. J Infect Dis. 1974 Jun;129(6):650–659. doi: 10.1093/infdis/129.6.650. [DOI] [PubMed] [Google Scholar]
- Washington A. E., Katz P. Cost of and payment source for pelvic inflammatory disease. Trends and projections, 1983 through 2000. JAMA. 1991 Nov 13;266(18):2565–2569. [PubMed] [Google Scholar]