Bilateral recurrent pyosalpinx in a sexually inactive 12-year-old girl secondary to rare variant of Mullerian duct anomaly

Abstract

Pyosalpinx is a severe sequel of chronic pelvic inflammatory disease, whereby the fallopian tubes become filled with pus.1 2 Pyosalpinx often affects sexually active women and rarely is seen in celibate adolescent girls.3 We report a case of a 12-year-old girl with no prior sexual history who presented to our emergency department with complaints of severe right lower quadrant pain of 1-day duration. Ultrasonography and CT scan of the abdomen and pelvis revealed free fluid collections in the pelvis without visualisation of the appendix. A preoperative diagnosis of acute ruptured appendicitis was given and she was taken to the operating room. Peroperative findings included bilaterally distended, pus-filled pyosalpinges. A definitive diagnosis of bilateral pyosalpinx was then made. Two-week antibiotic therapy was successful but the patient returned with recurrent pyosalpinx and a pelvic abscess 9 weeks later.

Fallopian tube abscess caused by Escherichia coli in a 12-year-old adolescent virgin: a case report and review of the literature

“…In this review of the literature, the most common causative organism of fallopian tube abscesses in adolescent virgins was E.coli, followed by S.pneumoniae, and occasionally Morganella morganii,Streptococcus group F,Fusobacterium nucleatum, Streptococcus anginosus, Peptostreptococcus anaerobius, Prevotella bivia. (Table 1) [7][8] .The causative agent of tubal abscess in this case was E. coli. Traditionally, broad-spectrum intravenous antibiotic infusion is the preferred treatment for pelvic abscess.In this case, broad-spectrum antibiotic cefoperazone sodium and metronidazole for anaerobic bacteria were chosen and the antibiotics were effective for their treatment.…”

Secondary pyosalpinx after reconstructive surgery of vaginal agenesis patient with bilateral hematosalpinx: A case report

“…PID is uncommon in non-sexually active females like in this case. The spectrum of PID is covering from upper female genital tracts disease such as endometritis, salpingitis, tubal ovarian abscess and pelvic peritonitis [7] . This goes along with this case that backflow of menstrual blood causing obstruction and increasing the risk of infection, specifically pyosalpix and tubal ovarium abscess (TOA).…”

“…There is no literature specifically discuss pyosalpinx pathogen in the non-sexually active patient. The study from Maraqa, a patient with pyosalpinx secondary due to agenesis ductus Mullerian, showed evidence of infection from peptostreptococcus anaerobic, prevutela bivia, Streptococcus anginosus [7] . In our case, the bacterium found was Klebsiella oxytoca .…”

“…Urogenital malformation was also reported to have a relation with pyosalpinx. Obesity as in the patient has a contribution to infection formation because it will make patient physically hard to clean and do personal hygiene [7] .…”

Morphofunctional Organization of the Uterine Tubes in the Conditions of Pathology

“…Результати проведених досліджень на білих щурах-самках показали розвиток структурних змін зі зміною просвіту труби. На відміну від контрольних тварин, слизова оболонка яких була гладкою, еластичною, в експериментальних тварин внаслідок дії золотистого стафілокока слизова оболонка маткових труб була тонкою, просвіт труби зменшений з наявністю запального інфільтрату та гною [50].…”