Streptococcus constellatus Tubo-ovarian Abscess in a Non-Sexually Active Adolescent Female

Pediatric Emergency Care
David MillsKari Schneider

Abstract

Tubo-ovarian abscess (TOA) in non-sexually active female adolescents is a rare presentation to the pediatric emergency department. In the following case, bilateral TOA secondary to Streptococcus constellatus was diagnosed in a 13-year-old virginal female. The patient was seen 4 months before presentation for interventional radiology-guided drainage and antibiotic treatment for an intra-abdominal abscess due to suspected appendiceal rupture. Exploratory laparotomy on the most recent presentation demonstrated an appendix with inflammation and serositis on pathology report, a concern for chronic appendicitis with microperforation and subsequent bacterial translocation of the bilateral ovaries. This case report identifies a rare cause, pathogen, and the patient's demographics presenting with bilateral TOA. Most importantly, this case demonstrates the need for emergency medicine physicians to have a high index of suspicion for TOA in patients with a significant medical history of intra-abdominal pathology to promptly diagnose and treat high-morbidity pathology.

References

Mar 1, 1988·Reviews of Infectious Diseases·J Gossling
Jan 23, 1999·Archives of Pediatrics & Adolescent Medicine·M M MooreM J Barrionuevo
Apr 24, 2001·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·J E ClaridgeS Dunbar
Jun 23, 2009·Journal of Pediatric and Adolescent Gynecology·K A HartmannM S Jay
Sep 26, 2012·Pediatrics International : Official Journal of the Japan Pediatric Society·Lashondria Simpson-CampSamuel M Alaish
Apr 10, 2013·Journal of Pediatric and Adolescent Gynecology·K GoodwinT Dumont

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