Oophoritis


Oophoritis

Description, Causes and Risk Factors:

Oophoritis is a type of female pelvic inflammatory disease that primarily affects the ovaries. It is caused by a bacterial infection, usually the result of a sexually transmitted disease (STD). Oophoritis can occur in women of any age, though it is most common in women between the ages of 15 and 25. A female who suffers from frequent abdominal pain, fever, vaginal discharge, or irregular menstrual patterns should visit her gynecologist, who can check for oophoritis and determine the underlying causes. Most infections can be treated with oral antibiotics, though severe cases may require hospitalization for more acute care.

The major causes of this disease are: more than one sexual partner, unprotected sexual intercourse, sexual behavior having a high element of risk, instrumentation of genital tract like intrauterine device [IUD] placement and endometrial biopsy, immunosuppression, and gynecologic malignancy.

Gonorrhea and Chlamydia typically are colonized from the cervix in cases of oophoritis, but these pathogens are rarely isolated in ovarian tissue. Rather, these organisms facilitate other bacteria to infect the adnexa. If left untreated, an abscess may form around the fallopian tubes and ovary, known as a tubo-ovarian abscess (TOA).

There are quite a few symptoms associated with this diseases, and some of these symptoms are pelvic pain, pain in the abdominal region, fever, vaginal discharge, chills, dyspareunia, vomiting and nausea.

Types:

    Acute oophoritis is characterized by the following symptoms: The patient complains of a dull, more or less intense, sometimes rather burning, but more frequently stinging, pain in the groin. If the patient be examined on her back, with the limbs drawn up, a deep-seated swelling, of variable size, is felt through the abdominal wall, directly over the horizontal ramus of the pubes, on one side of the median line of the abdomen. The pain sometimes extends to the adjoining parts, even to the thigh of the affected side, which feels numb and rigid; it is aggravated by the patient suddenly raising herself, and by straining at stool. The swelling is sometimes more distinctly felt by means of an examination per anum. If the swelling be large, the uterus is pushed to one side. There is generally a discharge of serum from the vagina, particularly during the fever paroxysm. The fever is either erethic or synochal, and is accompanied by a variety of nervous symptoms, such as, hysteric symptoms, spreading of the pain towards the stomach, nausea, spitting of water, vomiting, hysteric megrim, claims, which is sometimes attended with convulsions, delirium, which generally bears the character of nymphomania, etc.

  • Chronic oophoritis is easily confounded with hysteria. The pain is duller, and is only felt at the time of the menses, during an embrace, and after bodily exertions. There is a bearing-down sensation in the pubic region and perineum; at times, metrorrhagia; at others, suppression of the menses, leucorrhea. The swelling is not distinctly perceived at first.

There are several step woman can take to help lower their chances of developing oophoritis. Knowing about the sexual history of a partner and using condoms can significantly reduce the risk of contracting sexually transmitted diseases. Gynecologist often recommend that sexually active women schedule regular checkups to montior their reproductive system health. Finally, women can further reduce the likelihood of bacterial infection by maintaining good hygiene.

The prognosis depends upon the extent and character of the inflammation, and upon the diseases with which the inflammation happens to be complicated. According to Schoenlein, the prognosis is unfavourable, because the disease generally arises from moral causes which it is difficult for a physician to remove.

Symptoms:

Symptoms may include:

    Discomfort and cramping in the lower abdomen.

  • Unusual vaginal discharge.

  • Fever.

  • Chills.

  • Nausea.

  • Increase menstrual bleeding.

  • Pain while have urination or sex.

Signs:

    Primary amenorrhea (menstruation has never occurred).

  • Secondary amenorrhea (menstruation appeared at puberty but subsequently stopped).

  • Infertility.

  • Sex hormone deficiency.

Diagnosis:

Gynecologists check for oophoritis and sexually transmitted diseases by conducting physical exams and extracting samples of mucus and uterine tissue for laboratory analysis. Lab tests reveal the nature of a bacterial infection, and doctors use this information to confirm a diagnosis and prescribe treatment.

Tests:

Lab Studies:

    CBC - Elevation of the white blood cell count (WBC) to more than 10 K is a nonspecific indicator of infection. Early in the onset, however, the WBC may be normal.

  • Urinalysis - To rule out cystitis.

  • Urine pregnancy test - To rule out ectopic pregnancy.

  • Wet prep of cervical discharge - Shows numerous WBCs and bacteria.

  • Cervical cultures for gonococcus (GC) and Chlamydia - To rule out or diagnose and treat infection with these organisms (immediate results will not be available).

Imaging Studies: Pelvic ultrasound may be needed if the physical exam does not allow for a thorough palpation of the adnexa. This occurs commonly because patients guard due to the pain they experience. An ultrasound examination will rule out presence of a TOA. However, if a TOA is not present the ultrasound will probably not be helpful.

Other Tests: Diagnostic laparoscopy is the definitive test, usually reserved when diagnosis is unclear. Perform serologies for hepatitis B virus, hepatitis C virus, syphilis, and HIV, since these can be found in patients engaging in high-risk sexual behaviors.

Histologic Findings: For cases evaluated by surgery, an abscess involving the fallopian tubes and ovaries may be seen.

Treatment:

In most cases, oral antibiotics are effective at clearing up an infection in as little as one week. A woman who experiences severe pain may need to be admitted into a hospital so that doctors can administer intravenous antibiotics. In rare cases where an infection destroys ovarian tissue, emergency surgery is necessary to remove one or both ovaries.

Outpatient treatment is appropriate for patients who are (1) hemodynamically stable, (2) reliable to return for follow-up care, (3) immunocompetent, (4) not pregnant, (5) cannot tolerate oral medication due to nausea and vomiting, or (6) have no evidence of a TOA.

Inpatient treatment is required for patients who (1) have already failed outpatient treatment, (2) are pregnant, (3) are infected with HIV, or (4) have evidence of a TOA.

Surgical Care: Oophoritis may be managed with surgery when medical treatment has shown no amelioration of symptoms after 48-72 hours. Surgical options may include laparoscopy with drainage of the abscess, removal of adnexa, and total abdominal hysterectomy and bilateral salpingo-oophorectomy (TAHBSO). Factors that influence the type of surgery used include the extent of the abscess, the degree of immunocompromised of the patient, and preservation of fertility for future child bearing potential.

Interventional radiology can sometimes be used for drainage of abscesses in patients who are not surgical candidates.

NOTE: The above information is for processing purpose. The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition.

DISCLAIMER: This information should not substitute for seeking responsible, professional medical care.

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