Salmonella paratyphi A-infected ovarian cyst in returning traveller--an unusual complication of enteric fever

We report a case of Salmonella paratyphi A enteric fever in a returned New Zealand traveller complicated by an infected ovarian cyst, which resulted in clinical and microbiological relapse despite appropriate antibiotic treatment. Extraintestinal manifestations of enteric fever are infrequent but should be considered in situations where treatment response to first-line antibiotics for adequate duration is suboptimal.

[Fatal Clostridium sordellii infection originated in an ovarian cyst]

Clostridium sordellii is a Gram-positive bacterium which can cause a serious toxic shock syndrome with a mortality of up to 69%. C. sordellii is a part of the normal vaginal flora in up to 10% of all women. This case describes a fatal case of a healthy 49 year-old woman with a C. sordellii-infection originating from an ovarian cyst. Quick diagnosis is difficult because of the non-specific flu-like symptoms. Survival requires immediate source control and specific antibiotic therapy capable of suppressing toxin production. In rodents superantigen antibodies have shown neutralizing effects.

An unusual presentation of actinomycosis in a young woman, after surgery

Actinomycosis is an unusual, chronic granulomatous disease. Actinomyces israelli has been found to be related to infectious processes in those patients with affected skin integrity leading to abscess formation, fistulae or mass lesions. Actinomycosis mainly presents in three forms cervicofacial (50%), abdominal (20%) and thoracic (15%). Pelvic cases have been rarely reported and are usually associated with the use of intrauterine devices. We describe a case of a 23 y/o female without history of intrauterine device use, who was admitted with an ovarian cyst following an appendectomy. An ovarian abscess was drained. The pathology showed a granuloma and focal sulfur granules like particles compatible with Actinomyces. This is a case of pelvic Actinomyces, not related to the use of an intrauterine device.

Production, reproductive, and metabolic factors associated with chlamydial seropositivity and reproductive tract antigens in dairy herds with fertility disorders

While chlamydial infections cause abortions in cattle, its role in other reproductive disorders is uncertain. This study identified the risk factors for chlamydial infection in herds with history of subfertility. We investigated the possible effects of coinfections, different metabolic parameters, abortion, ovarian cysts, pathological vaginal discharge, length of the open period, milk yield, housing conditions and age. In cows from 34 farms with elevated reproductive disorders, 41.5% had antibodies against chlamydia, while chlamydia antigen was detected in the vagina and uterus of 46.7%. A statistical relationship between seropositivity and antigen positivity was not found. Abortion (OR = 6.6) and loose housing (OR = 2.3) were risk factors for the presence of chlamydia antibodies. Furthermore, there were significant relationships between metabolic disorders and chlamydial infections. Increased levels of beta-hydroxybutaric acid (OR = 6.8) and hypocalcaemia (OR = 6.0) often accompanied chlamydia antigen in the vagina. Increased age (OR = 1.2) and pathological vaginal discharge (OR = 2.4) were identified as risk factors for chlamydia antigen in the vagina. The largest risk factor was for the association of ovarian cysts (OR = 21.5) with uterine antigen. In conclusion, chlamydial infection in dairy herd cows is best understood as a multifactorial disease.

[Pelvic inflammatory disease-- microbial findings]

During the period 1997-2001 in the Microbiological laboratory of University Hospital "Maichin don" 20 women with clinical diagnoses of obs. kysta ovarii, 3 with obs. grav. extrauterina, 9 with pyosalpinx, 37 with TOA, 14 women with pelveoperitonitis were examined. The microbial findings of examined aspirates from CD and materials taken by means of surgical intervention have been presented. The importance of the evaluation of direct microscopical preparation (dmp) from the materials examined fir any existing inflammatory process has been clearly defined. In 14 of the cases (19.1%) in the presence of lot of Leuc in dmp the examined purulent collections didn't show evidence of growth of microorganisms. In the age group 16-25 in 4 of the examined 29 women with acute PID there has been found a positive culture of N. gonorrhoeae. The highest percentage as the cause of TOA and pelveoperitonitis has been attributed to association of microorganisms with anaerobic species having the leading part.

[Evaluation of incidence of Chlamydia trachomatis infections among the group of infertile women diagnosed by laparoscopy, and based on properties of Chlamydia trachomatis in the cervical canal, peritoneal fluid and ovarian cyst puncture]

The number of 75 patients who underwent diagnostic et operative laparoscopy was analysed. The percentage of infection cases caused by Chlamydia Trachomatis was 9.33% investigations proved correlation between fallopian tube factor and infection. It seems that pelvic infection not always undergoes with infection of uterine cervix.

[Secondary infection of the ovarian endometriotic cysts]

OBJECTIVE

To explore the clinic manifestations, diagnostic methods and principles of management in the secondary infection of the endometriotic cysts of ovary.

METHODS

Thirteen cases of the infected ovarian endometriotic cysts were analysed retrospectively in our hospital from Jan. 1990 to Dec. 1996. The diagnosis was confirmed by the operation and pathologic findings.

RESULTS

The clinic manifestations were divided into five types, namely acute, subacute, chronic, occult and stabile types. The definitive diagnosis can be made by abdominal pain, fever and adnexal mass combined with B-scan findings and chocolate-brown purulent fluid which was punctured from the adnexal mass. Operation was the main method for treatment.

CONCLUSIONS

Secondary infection of the endometriotic cyst is one of the gynecologic emergency. Correct diagnosis and prompt management are of vital importance.

Reproductive tract lesions in heifers after intrauterine inoculation with infectious bovine rhinotracheitis virus

Cross-breed heifers given infectious bovine rhinotracheitis virus by intrauterine inoculation 1 day after natural mating with a noninfected bull were killed on postinoculation days 4 to 14. When reproductive organs were examined for gross and microscopic lesions and for virus infection, the most severe uterine lesions were found in the body and caudal portions of the uterine horns of heifers killed between postinoculation days 4 and 9. Primary pathologic features were necrosis, edema, hemorrhage, and a diffuse accumulation of mononuclear cells, mostly lymphocytes; numerous lymphocytes were in mitosis. In cranial parts of uterine horns, the only lesions observed were a few small lymphocytic foci in the endometrial lamina propria. Lesions were not seen in the oviducts. In many heifers, the ovarian corpus luteum (CL) was cystic. In a few of these heifers, the cyst had a necrotic wall that was bordered by a zone of proliferating mononuclear cells. Focal necrosis and lymphoid proliferation were common in the parenchyma of cystic and noncystic CL. Similar necrotizing lesions were sometimes present in non-CL ovarian tissue. Infectious bovine rhinotracheitis virus was most frequently isolated from the uterine body, the internal os of the cervix, and the CL. Isolations were not made from blood samples taken at the time of necropsy. Isolation of virus from the CL correlated with the detection of luteal inflammation by light microscopy, but did not correlate with the presence of cysts. There also was no correlation between cystic CL and the severity of uterine lesions.