Topic Completed: 1 August 2011

Minor changes: 5 May 2020

Copyright: 2002-2020, PathologyOutlines.com, Inc.

PubMed Search: "Ovarian abscess" infectious

Mohiedean Ghofrani, M.D.
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Cite this page: Ghofrani M. Abscess. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/ovarynontumorabscess.html. Accessed August 6th, 2020.
Definition / general
  • Nonspecific abscess localized to the ovary
  • Primary ovarian abscess is defined as inflammation arising in the ovarian tissue
  • Secondary ovarian abscess originates in extraovarian sites
  • Primary ovarian abscesses are quite rare; most cases of ovarian abscess are secondary
  • Primary abscesses may arise due to disruption of ovarian capsule, as in ovulation or surgical intervention (vaginal hysterectomy, ovarian cystectomy, caesarean section, pregnancy, use of intrauterine device, transvaginal or percutaneous needle aspiration of endometrioma or follicle aspiration as part of in vitro fertilization, Tunis Med 2010;88:285), which gives bacteria access to the ovarian stroma
  • Also occurs due to hematogenous and lymphatic spread
  • Secondary ovarian abscess may be associated with tubo-ovarian abscess, salpingitis, ascending infection of lower genital tract (pelvic inflammatory disease) or complication of GI infections (diverticulitis, appendicitis)
Clinical features
  • Nonspecific symptoms, making diagnosis difficult
  • Time between capsule disruption and clinical presentation depends on bacterial inoculum dose, type and virulence and if infection occurred secondary to direct contamination at surgery or via devitalized tissue
  • Most common infectious organisms are Streptococcus type B; other bacteria
Case reports
  • Initial treatment is intravenous antibiotics
  • If no response within 72 hours, if abscess ruptures or if surrounding organs are affected, immediate laparoscopy or laparotomy with removal of the ovary is the main treatment
Gross description
  • Large, loculated cyst with pus or secretion
Gross images

AFIP images

Tubo-ovarian abscess complicating colonic diverticulitis - the left ovary and tube have been transformed into a multicystic mass with a yellow lining

Ovarian abscess associated with Crohn's disease shows replacement of the ovarian tissue by yellow, soft tissue

Microscopic (histologic) description
  • Cyst wall often contains ovarian stroma
Microscopic (histologic) images

AFIP images

Ovarian stroma is replaced by collagenous tissue containing numerous chronic inflammatory cells / xanthogranuloma

Contributed by Eman Abdelzaher, M.D., Ph.D.

Tubo-ovarian actinomycosis

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