title: Postmenopausal tubo-ovarian abscess due to Pseudomonas aeruginosa in a renal transplant patient: a case report and review of the literature.
abstract: BACKGROUND
  Pseudomonas aeruginosa is an uncommon cause of infection in the female genital tract. We report a case of postmenopausal tubo-ovarian abscess (TOA) due to P. aeruginosa in a renal transplant recipient. The presentation included mild abdominal symptoms with rapid progression of peritonitis and surgical abscess drainage. This is the first such case in an organ transplant recipient described in the English literature.
  
  
  RESULTS
  Published reports of 1040 cases of TOA were reviewed. The most common features were a history of sexually transmitted disease or pelvic inflammatory disease, and symptoms including abdominal pain and fever. Escherichia coli, Bacteroides spp., and Klebsiella pneumoniae were the most frequently encountered pathogens. Neisseria gonorrhoeae and Chlamydia trachomatis, which are frequently isolated from cervical cultures, are uncommonly isolated from tubo-ovarian abscesses. Forty percent of patients were treated with antibiotics alone, 18.8% with abdominal surgery, and 32% with surgery and antimicrobial therapy.
  
  
  CONCLUSIONS
  This report illustrates the muted presentation and atypical microbiology of gynecologic infection in an organ transplant recipient.
authors.affiliation: Infectious Disease Division, GRJ 504, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA.
authors.forename: J
authors.initials: J
authors.lastname: El Khoury
authors.forename: M M
authors.initials: MM
authors.lastname: Stikkelbroeck
authors.forename: A
authors.initials: A
authors.lastname: Goodman
authors.forename: R H
authors.initials: RH
authors.lastname: Rubin
authors.forename: A B
authors.initials: AB
authors.lastname: Cosimi
authors.forename: J A
authors.initials: JA
authors.lastname: Fishman
mesh_terms: D000038:Abscess / Q000209:etiology*; D005184:Fallopian Tube Diseases / Q000209:etiology*; D005260:Female; D006801:Humans; D007165:Immunosuppression Therapy / Q000009:adverse effects*; D016030:Kidney Transplantation; D008875:Middle Aged; D010049:Ovarian Diseases / Q000209:etiology*; D017698:Postmenopause; D011552:Pseudomonas Infections / Q000209:etiology*