Ovary
Inflammatory
Abscess
Author: Mohiedean Ghofrani, M.D.
Last author update: 1 August 2011
Last staff update: 14 October 2020
Copyright: 2002-2023, PathologyOutlines.com, Inc.
PubMed Search: "Ovarian abscess" infectious
Table of Contents
Definition / general | Epidemiology | Etiology | Clinical features | Laboratory | Case reports | Treatment | Gross description | Gross images | Microscopic (histologic) description | Microscopic (histologic) imagesCite this page: Ghofrani M. Abscess. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/ovarynontumorabscess.html. Accessed June 5th, 2023.
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
Epidemiology
- Primary ovarian abscesses are quite rare; most cases of ovarian abscess are secondary
Etiology
- 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
Laboratory
- Most common infectious organisms are Streptococcus type B; other bacteria
Case reports
- Two cases of Brucella ovarian abscess (J Clin Ultrasound 2007;35:395)
- Enterobius vermicularis infection with tubo-ovarian abscess and peritonitis occurring during pregnancy (Surg Infect (Larchmt) 2009;10:545)
- Tubo-ovarian abscess with Morganella morganii bacteremia (J Microbiol Immunol Infect 2009;42:357)
- Abdominal abscesses with Streptococcus milleri group after laparoscopic chromopertubation (Acta Obstet Gynecol Scand 2010;89:982)
Treatment
- 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
Ovarian abscess
associated with
Crohn's disease
Microscopic (histologic) description
- Cyst wall often contains ovarian stroma
Microscopic (histologic) images
AFIP images
Ovarian stroma
is replaced by
collagenous tissue
Contributed by Eman Abdelzaher, M.D., Ph.D.
Tubo-ovarian actinomycosis
