Taylor Gregory M, Erlich Andrew H, Wallace Laurie C, Williams Vernon, Ali Reehan M, Zygowiec Jonathan P
Indiana University School of Medicine, Ball Memorial Hospital, Muncie, IN, USA. Department of Emergency Medicine. Assistant Professor of Clinical Emergency Medicine.
Beaumont Hospital, Farmington Hills, MI.
Oxf Med Case Reports. 2019 Aug 1;2019(8). doi: 10.1093/omcr/omz071.
A tubo-ovarian abscess (TOA) is a relatively rare medical complication that results from an untreated/unrecognized ascending pelvic infection of the female genital tract. In a right-sided TOA, this clinical entity may mimic appendicitis on computed tomography (CT). In addition, both disease processes can present with pelvic pain, leukocytosis and fever. We present the case of a 47-year-old female with mid right-sided abdominal pain that was diagnosed on CT scan with an appendiceal abscess. She underwent CT-guided percutaneous drainage with interventional radiology. On Day 8, a CT limited study involving a contrast injection was performed to evaluate for abscess resolution. The contrast within the drain filled the fallopian tube, endometrial cavity and contralateral fallopian tube. These findings demonstrated that the initial diagnosis actually represented a TOA. To the authors' knowledge, this is the only reported case involving a TOA secondary to Streptococcus agalactiae (GBS) mimicking an appendicitis with abscess formation.
输卵管卵巢脓肿（TOA）是一种相对罕见的医学并发症，由女性生殖道未经治疗/未被识别的上行性盆腔感染引起。在右侧TOA中，这种临床病症在计算机断层扫描（CT）上可能类似阑尾炎。此外，这两种疾病过程都可能表现为盆腔疼痛、白细胞增多和发热。我们报告一例47岁女性，她因右侧中腹部疼痛接受CT扫描诊断为阑尾脓肿。她接受了介入放射科的CT引导下经皮引流。在第8天，进行了一项涉及造影剂注射的CT有限研究以评估脓肿消散情况。引流管内的造影剂充盈了输卵管、子宫内膜腔和对侧输卵管。这些发现表明最初的诊断实际上是TOA。据作者所知，这是唯一一例报告的由无乳链球菌（GBS）引起的TOA继发脓肿形成并类似阑尾炎的病例。
