Tubo-ovarian abscess formation in users of intrauterine devices remote from insertion

A report of three cases

Marc R. Toglia, Joseph I. Schaffer

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Background: The association between tubo-ovarian abscess formation and the presence of an intrauterine device (IUD) is well recognized. It has been suggested that the risk of upper-genital-tract infection is highest during the immediate period following the insertion of an IUD, returning to baseline by 5 months postinsertion. We present 3 cases of women who, 10-21 years after insertion of their IUDs, developed tubo-ovarian abscesses that were not causally related to sexually transmitted diseases (STDs) or actinomycetes. Cases: Three women, ages 39-47 years, presented to our gynecology service for evaluation of abdominal pain. One woman had bilateral tubo-ovarian abscesses and the other 2 had unilateral tubo-ovarian abscesses. All 3 were IUD users, with an interval from IUD insertion to presentation of 10-21 years. In each case, the cervical cultures for gonorrhea and chlamydia were negative at presentation and the sexual history was not consistent with an STD mode of spread. All 3 women initially received broad-spectrum antibiotics, but 2 eventually required definitive surgical therapy. Conclusion: Long-term users of IUDs remain at risk for serious, indolent pelvic infections. These women should be counseled by their gynecologists on an ongoing basis as to this persistent risk. Tubo-ovarian abscess should be strongly considered in the differential diagnosis of an IUD user who presents with an adnexal mass, fever, or abdominal pain.

Original languageEnglish (US)
Pages (from-to)85-88
Number of pages4
JournalInfectious Diseases in Obstetrics and Gynecology
Volume4
Issue number2
DOIs
StatePublished - 1996

Fingerprint

Intrauterine Devices
Abscess
Sexually Transmitted Diseases
Abdominal Pain
Pelvic Infection
Reproductive Tract Infections
Chlamydia
Actinobacteria
Gonorrhea
Gynecology
Differential Diagnosis
Fever
Anti-Bacterial Agents

Keywords

  • pelvic abscess
  • Pelvic inflammatory disease
  • salpingitis

ASJC Scopus subject areas

  • Obstetrics and Gynecology
  • Dermatology

Cite this

@article{115154215de4400093c46b9920bb63c3,
title = "Tubo-ovarian abscess formation in users of intrauterine devices remote from insertion: A report of three cases",
abstract = "Background: The association between tubo-ovarian abscess formation and the presence of an intrauterine device (IUD) is well recognized. It has been suggested that the risk of upper-genital-tract infection is highest during the immediate period following the insertion of an IUD, returning to baseline by 5 months postinsertion. We present 3 cases of women who, 10-21 years after insertion of their IUDs, developed tubo-ovarian abscesses that were not causally related to sexually transmitted diseases (STDs) or actinomycetes. Cases: Three women, ages 39-47 years, presented to our gynecology service for evaluation of abdominal pain. One woman had bilateral tubo-ovarian abscesses and the other 2 had unilateral tubo-ovarian abscesses. All 3 were IUD users, with an interval from IUD insertion to presentation of 10-21 years. In each case, the cervical cultures for gonorrhea and chlamydia were negative at presentation and the sexual history was not consistent with an STD mode of spread. All 3 women initially received broad-spectrum antibiotics, but 2 eventually required definitive surgical therapy. Conclusion: Long-term users of IUDs remain at risk for serious, indolent pelvic infections. These women should be counseled by their gynecologists on an ongoing basis as to this persistent risk. Tubo-ovarian abscess should be strongly considered in the differential diagnosis of an IUD user who presents with an adnexal mass, fever, or abdominal pain.",
keywords = "pelvic abscess, Pelvic inflammatory disease, salpingitis",
author = "Toglia, {Marc R.} and Schaffer, {Joseph I.}",
year = "1996",
doi = "10.1002/(SICI)1098-0997(1996)4:2<85::AID-IDOG7>3.0.CO;2-6",
language = "English (US)",
volume = "4",
pages = "85--88",
journal = "Infectious Diseases in Obstetrics and Gynecology",
issn = "1064-7449",
publisher = "Hindawi Publishing Corporation",
number = "2",

}

TY - JOUR

T1 - Tubo-ovarian abscess formation in users of intrauterine devices remote from insertion

T2 - A report of three cases

AU - Toglia, Marc R.

AU - Schaffer, Joseph I.

PY - 1996

Y1 - 1996

N2 - Background: The association between tubo-ovarian abscess formation and the presence of an intrauterine device (IUD) is well recognized. It has been suggested that the risk of upper-genital-tract infection is highest during the immediate period following the insertion of an IUD, returning to baseline by 5 months postinsertion. We present 3 cases of women who, 10-21 years after insertion of their IUDs, developed tubo-ovarian abscesses that were not causally related to sexually transmitted diseases (STDs) or actinomycetes. Cases: Three women, ages 39-47 years, presented to our gynecology service for evaluation of abdominal pain. One woman had bilateral tubo-ovarian abscesses and the other 2 had unilateral tubo-ovarian abscesses. All 3 were IUD users, with an interval from IUD insertion to presentation of 10-21 years. In each case, the cervical cultures for gonorrhea and chlamydia were negative at presentation and the sexual history was not consistent with an STD mode of spread. All 3 women initially received broad-spectrum antibiotics, but 2 eventually required definitive surgical therapy. Conclusion: Long-term users of IUDs remain at risk for serious, indolent pelvic infections. These women should be counseled by their gynecologists on an ongoing basis as to this persistent risk. Tubo-ovarian abscess should be strongly considered in the differential diagnosis of an IUD user who presents with an adnexal mass, fever, or abdominal pain.

AB - Background: The association between tubo-ovarian abscess formation and the presence of an intrauterine device (IUD) is well recognized. It has been suggested that the risk of upper-genital-tract infection is highest during the immediate period following the insertion of an IUD, returning to baseline by 5 months postinsertion. We present 3 cases of women who, 10-21 years after insertion of their IUDs, developed tubo-ovarian abscesses that were not causally related to sexually transmitted diseases (STDs) or actinomycetes. Cases: Three women, ages 39-47 years, presented to our gynecology service for evaluation of abdominal pain. One woman had bilateral tubo-ovarian abscesses and the other 2 had unilateral tubo-ovarian abscesses. All 3 were IUD users, with an interval from IUD insertion to presentation of 10-21 years. In each case, the cervical cultures for gonorrhea and chlamydia were negative at presentation and the sexual history was not consistent with an STD mode of spread. All 3 women initially received broad-spectrum antibiotics, but 2 eventually required definitive surgical therapy. Conclusion: Long-term users of IUDs remain at risk for serious, indolent pelvic infections. These women should be counseled by their gynecologists on an ongoing basis as to this persistent risk. Tubo-ovarian abscess should be strongly considered in the differential diagnosis of an IUD user who presents with an adnexal mass, fever, or abdominal pain.

KW - pelvic abscess

KW - Pelvic inflammatory disease

KW - salpingitis

UR - http://www.scopus.com/inward/record.url?scp=0029804558&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0029804558&partnerID=8YFLogxK

U2 - 10.1002/(SICI)1098-0997(1996)4:2<85::AID-IDOG7>3.0.CO;2-6

DO - 10.1002/(SICI)1098-0997(1996)4:2<85::AID-IDOG7>3.0.CO;2-6

M3 - Article

VL - 4

SP - 85

EP - 88

JO - Infectious Diseases in Obstetrics and Gynecology

JF - Infectious Diseases in Obstetrics and Gynecology

SN - 1064-7449

IS - 2

ER -