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1.  Endometrioma Complicated by Tubo-Ovarian Abscess in a Woman With Bacterial Vaginosis 
Background. Tubo-ovarian abscess involvement of an endometrioma has been reported in cases of patients with polymicrobial sources such as Neisseria gonorrhoeae, Chlamydia trachomatis, and obligate anaerobic bacteria; however, bacterial vaginosis (BV) predisposing to abscess formation in an endometrioma has not been reported to date. Case. Superinfection of an endometrioma was surgically diagnosed in a patient with known advanced-stage endometriosis after she presented with acute pelvic inflammatory disease symptoms and was unresponsive to antibiotic therapy. Gram-negative rods were cultured from the endometrioma. On admission, cervical, blood, and urine cultures were negative; BV was diagnosed on normal saline wet prep and gram stain. Conclusion. This case raises the possibility of BV ascension to the upper genital tract predisposing to abscess formation in endometriomas. Therefore, aggressive treatment of BV in patients with known advanced-stage endometriosis may be considered to prevent superinfected endometriomas.
PMCID: PMC1779615  PMID: 17485813
2.  Mycobacterium chelonei Breast Abscess Associated With Nipple Piercing 
Background: Breast abscesses are typically seen in the setting of complicated mastitis in lactating women. Abscesses resulting from foreign bodies are not commonly seen in the breast. Over the past few decades, body piercing has become increasingly common, yet the infectious morbidity resulting from it is not well recognized. A breast abscess associated with nipple piercing is described in this report.
Case: A 19-year-old woman developed a breast abscess approximately 10 weeks after the placement of a nipple ring. Multiple drainage procedures were performed before the infection was controlled. The cultures grew Mycobacterium chelonei, an organism not commonly causing soft-tissue infection.
Conclusion: Body piercing may be associated with significant infections. The use of sterile equipment and techniques should be used to prevent these uncommon infections.
PMCID: PMC2364426  PMID: 18476032
3.  Amniotic Fluid Glucose Concentration: A Marker for Infection in Preterm Labor and Preterm Premature Rupture of Membranes 
Amniotic fluid Gram stain and culture have been utilized as laboratory tests of microbial invasion of the amniotic cavity. The Gram stain of amniotic fluid has a low sensitivity in the detection of clinical infection or microbial invasion of the amniotic cavity, and amniotic fluid culture results are not immediately available for management decisions. Glucose concentration is used to diagnose infection in other sites such as cerebrospinal fluid.
Objective: The purpose of this study was to evaluate the usefulness of amniotic fluid glucose concentration in detecting microbial invasion of the amniotic cavity associated with preterm labor and preterm premature rupture of membranes.
Methods: Amniocentesis was performed in 60 women with preterm labor and/or preterm premature rupture of membranes. Gram stain and culture for Mycoplasma hominis, Ureaplasma urealyticum, aerobic, and anaerobic bacteria were performed. Subjects were studied prospectively for the development of positive amniotic fluid cultures and the development of clinical chorioamnionitis.
Results: The diagnosis of clinical chorioamnionitis was made in 25% (15/60) of women entered into the study. Low amniotic fluid glucose concentration Was considered < 15 mg/dl. The sensitivity, specificity, and positive predictive value of low amniotic, fluid glucose concentration to predict clinical chorioamnionitis were 73.3%, 88.1%, and 68.8% respectively, while positive amniotic fluid culture, hada sensitivity of 43.8%, specificity of 79.5%, and positive predictive value of 43.8%.
Conclusions: Amniotic fluid glucose concentration was more sensitive in predicting chorioamnionitis than either Gram stain or culture. Amniotic fluid glucose concentration was better in predicting clinical chorioamnionitis than predicting positive amniotic fluid culture results. Gestational age-dependent normal ranges and pathologic conditions that may alter amniotic fluid glucose concentrations should be considered when interpreting amniotic fluid glucose values to diagnose microbial invasion of the amniotic cavity.
PMCID: PMC2364340  PMID: 18475339
4.  Development of Pelvic Abscess Following Water-Skiing Injury 
Several descriptions of hydrostatic injuries while water-skilng have been described, including lacerations of the perineum, vagina, and cervix. Salpingitis or pelvic abscess resulting from water-skiing injuries are rare but important complications. A case of a pelvic abscess following a fall while water-skiing is described. The abscess was drained laparoscopically, resulting in a good clinical outcome. The mechanism of injury and recommendations for prevention are also presented. Upper genital tract infection may result from water-skiing injuries due to hydrostatic pressure forcing bacteria and water through the vagina and cervix into the endometrium, fallopian tube, and peritoneal cavity. While an uncommon complication, physicians and other practitioners caring for women should be aware of this potential complication from water-skiing.
PMCID: PMC2364678  PMID: 18476207

Results 1-4 (4)