A case report of Tubo-ovarian abscess caused by Burkholderia pseudomallei
Abstract Background Melioidosis, the disease caused by Burkholderia pseudomallei is endemic in the Northeastern part of Thailand, South-East Asia, and Northern Australia. The pelvic involvement of disease is rare even in an endemic area. Therefore, we describe in this report the clinical presentatio...
| Main Authors: | , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2018-02-01
|
| Series: | BMC Infectious Diseases |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s12879-018-2986-z |
| _version_ | 1818294441723559936 |
|---|---|
| author | Pattaranit Nernsai Areepan Sophonsritsuk Srithean Lertvikool Artit Jinawath Maria Nina Chitasombat |
| author_facet | Pattaranit Nernsai Areepan Sophonsritsuk Srithean Lertvikool Artit Jinawath Maria Nina Chitasombat |
| author_sort | Pattaranit Nernsai |
| collection | DOAJ |
| description | Abstract Background Melioidosis, the disease caused by Burkholderia pseudomallei is endemic in the Northeastern part of Thailand, South-East Asia, and Northern Australia. The pelvic involvement of disease is rare even in an endemic area. Therefore, we describe in this report the clinical presentation, management, and outcome of the patient with primary tubo-ovarian abscess due to melioidosis. Case presentation A 31-year-old Thai cassava farmer woman presented with fever and abdominal pain at left lower quadrant for one month. She also had pain, swelling, and redness of the genitalia without any ulcer. She had odorless whitish vaginal discharge. The pelvic examination revealed excitation pain on the left side of her cervix. Transvaginal ultrasonography revealed a large left tubo-ovarian abscess size 9.4 × 4.8 cm located at anterior of the uterus. Urgent exploratory laparotomy revealed left hydrosalpinx with a large amount of pus. The pus culture grew Burkholderia pseudomallei. The computer tomography of the abdomen revealed multiple hepatosplenic abscesses. The patient underwent left salpingo-oophorectomy and pus drainage. The pathological examination of excised left adnexa revealed chronic and acute suppurative inflammation with necrotic tissue. She was given intravenous ceftazidime for one month, and her clinical symptom improved. She was diagnosed with type 2 diabetes mellitus at this visit and treated with insulin injection. She continued to take oral co-trimoxazole for 20 weeks. The final diagnosis was disseminated melioidosis with left tubo-ovarian abscess and hepatosplenic abscesses in a newly diagnosed morbidly obese diabetic patient. Conclusion Burkholderia pseudomallei should be considered as the causative organism of gynecologic infection among patient with risk factor resided in an endemic area who do not respond to standard antibiotics. The pus culture from the site of infection is the only diagnostic method of pelvic melioidosis, appropriate antibiotics, and adequate surgical drainage were the components of the successful outcome. |
| first_indexed | 2024-12-13T03:31:48Z |
| format | Article |
| id | doaj.art-2218f4e71bb949ee9529806747949d87 |
| institution | Directory Open Access Journal |
| issn | 1471-2334 |
| language | English |
| last_indexed | 2024-12-13T03:31:48Z |
| publishDate | 2018-02-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Infectious Diseases |
| spelling | doaj.art-2218f4e71bb949ee9529806747949d872022-12-22T00:01:09ZengBMCBMC Infectious Diseases1471-23342018-02-011811410.1186/s12879-018-2986-zA case report of Tubo-ovarian abscess caused by Burkholderia pseudomalleiPattaranit Nernsai0Areepan Sophonsritsuk1Srithean Lertvikool2Artit Jinawath3Maria Nina Chitasombat4Division of Infectious Disease, Department of Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol UniversityDepartment of Obstetrics and Gynecology, Faculty of Medicine Ramathibodi Hospital, Mahidol UniversityDepartment of Obstetrics and Gynecology, Faculty of Medicine Ramathibodi Hospital, Mahidol UniversityDepartment of Pathology, Faculty of Medicine Ramathibodi Hospital, Mahidol UniversityDivision of Infectious Disease, Department of Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol UniversityAbstract Background Melioidosis, the disease caused by Burkholderia pseudomallei is endemic in the Northeastern part of Thailand, South-East Asia, and Northern Australia. The pelvic involvement of disease is rare even in an endemic area. Therefore, we describe in this report the clinical presentation, management, and outcome of the patient with primary tubo-ovarian abscess due to melioidosis. Case presentation A 31-year-old Thai cassava farmer woman presented with fever and abdominal pain at left lower quadrant for one month. She also had pain, swelling, and redness of the genitalia without any ulcer. She had odorless whitish vaginal discharge. The pelvic examination revealed excitation pain on the left side of her cervix. Transvaginal ultrasonography revealed a large left tubo-ovarian abscess size 9.4 × 4.8 cm located at anterior of the uterus. Urgent exploratory laparotomy revealed left hydrosalpinx with a large amount of pus. The pus culture grew Burkholderia pseudomallei. The computer tomography of the abdomen revealed multiple hepatosplenic abscesses. The patient underwent left salpingo-oophorectomy and pus drainage. The pathological examination of excised left adnexa revealed chronic and acute suppurative inflammation with necrotic tissue. She was given intravenous ceftazidime for one month, and her clinical symptom improved. She was diagnosed with type 2 diabetes mellitus at this visit and treated with insulin injection. She continued to take oral co-trimoxazole for 20 weeks. The final diagnosis was disseminated melioidosis with left tubo-ovarian abscess and hepatosplenic abscesses in a newly diagnosed morbidly obese diabetic patient. Conclusion Burkholderia pseudomallei should be considered as the causative organism of gynecologic infection among patient with risk factor resided in an endemic area who do not respond to standard antibiotics. The pus culture from the site of infection is the only diagnostic method of pelvic melioidosis, appropriate antibiotics, and adequate surgical drainage were the components of the successful outcome.http://link.springer.com/article/10.1186/s12879-018-2986-zBurkholderia pseudomalleiMelioidosisOvarian abscessPelvic inflammatory disease |
| spellingShingle | Pattaranit Nernsai Areepan Sophonsritsuk Srithean Lertvikool Artit Jinawath Maria Nina Chitasombat A case report of Tubo-ovarian abscess caused by Burkholderia pseudomallei BMC Infectious Diseases Burkholderia pseudomallei Melioidosis Ovarian abscess Pelvic inflammatory disease |
| title | A case report of Tubo-ovarian abscess caused by Burkholderia pseudomallei |
| title_full | A case report of Tubo-ovarian abscess caused by Burkholderia pseudomallei |
| title_fullStr | A case report of Tubo-ovarian abscess caused by Burkholderia pseudomallei |
| title_full_unstemmed | A case report of Tubo-ovarian abscess caused by Burkholderia pseudomallei |
| title_short | A case report of Tubo-ovarian abscess caused by Burkholderia pseudomallei |
| title_sort | case report of tubo ovarian abscess caused by burkholderia pseudomallei |
| topic | Burkholderia pseudomallei Melioidosis Ovarian abscess Pelvic inflammatory disease |
| url | http://link.springer.com/article/10.1186/s12879-018-2986-z |
| work_keys_str_mv | AT pattaranitnernsai acasereportoftuboovarianabscesscausedbyburkholderiapseudomallei AT areepansophonsritsuk acasereportoftuboovarianabscesscausedbyburkholderiapseudomallei AT sritheanlertvikool acasereportoftuboovarianabscesscausedbyburkholderiapseudomallei AT artitjinawath acasereportoftuboovarianabscesscausedbyburkholderiapseudomallei AT marianinachitasombat acasereportoftuboovarianabscesscausedbyburkholderiapseudomallei AT pattaranitnernsai casereportoftuboovarianabscesscausedbyburkholderiapseudomallei AT areepansophonsritsuk casereportoftuboovarianabscesscausedbyburkholderiapseudomallei AT sritheanlertvikool casereportoftuboovarianabscesscausedbyburkholderiapseudomallei AT artitjinawath casereportoftuboovarianabscesscausedbyburkholderiapseudomallei AT marianinachitasombat casereportoftuboovarianabscesscausedbyburkholderiapseudomallei |