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Endocrinology11 papers

Tubo-ovarian abscess

Last edited: 4/16/2026

Overview

Tubo-ovarian abscess (TOA) is a severe pelvic infection involving the fallopian tube and ovary, often complicating pelvic inflammatory disease (PID). Isolated ovarian abscesses without tubal involvement are exceptionally rare 1.

Diagnosis

  • Clinical presentation includes fever, lower abdominal pain, and signs of systemic infection
  • Imaging (pelvic ultrasound, CT scan) essential for diagnosis, showing fluid collections with or without gas bubbles
  • Laboratory tests: elevated white blood cell count, C-reactive protein, and erythrocyte sedimentation rate
  • Definitive diagnosis often requires imaging findings and clinical context 1

    • Management

  • First-line treatment: Intravenous (IV) antibiotics targeting polymicrobial infection (e.g., broad-spectrum coverage including ceftriaxone, metronidazole)
  • Surgical intervention: Often required for definitive management, including drainage or salpingo-oophorectomy in severe cases
  • Supportive care: Fluid resuscitation, management of sepsis, and close monitoring in ICU if necessary
  • Duration: Antibiotics typically continued for 2-4 weeks, adjusted based on clinical response and imaging 1

    • Special Populations

  • Pregnancy: Management complex; IV antibiotics preferred initially, with close monitoring and potential surgical intervention if abscess persists or worsens 1
  • Pediatrics: Limited specific data; treatment similar to adults but with closer pediatric-specific care adjustments 1
  • Elderly: Increased risk of complications; tailored antibiotic therapy and vigilant monitoring essential 1
  • Comorbidities: Presence of comorbidities may necessitate more aggressive management and closer follow-up 1

    • Key Recommendations

  • Initiate broad-spectrum IV antibiotics targeting both gram-positive and gram-negative organisms for suspected TOA (Evidence: Moderate 1)
  • Consider surgical intervention for abscess drainage or removal if medical management fails or complications arise (Evidence: Moderate 1)
  • Close monitoring and supportive care are crucial, especially in high-risk groups like pregnant women and the elderly (Evidence: Expert opinion 1)

    • References

    1 Harrison NA. Ovarian abscess. A case report and review of the literature. South African medical journal = Suid-Afrikaanse tydskrif vir geneeskunde 1978. link

    Original source

    1. [1]
      Ovarian abscess. A case report and review of the literature. — Harrison NA South African medical journal = Suid-Afrikaanse tydskrif vir geneeskunde (1978)
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