title: Endometrioma complicated by tubo-ovarian abscess in a woman with bacterial vaginosis.
abstract: 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.
  
  
  METHODS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, MI 48109-0276, USA.
authors.forename: Shahryar K
authors.initials: SK
authors.lastname: Kavoussi
authors.forename: Mark D
authors.initials: MD
authors.lastname: Pearlman
authors.forename: William M
authors.initials: WM
authors.lastname: Burke
authors.forename: Dan I
authors.initials: DI
authors.lastname: Lebovic
mesh_terms: D000038:Abscess / Q000150:complications* / Q000473:pathology; D000328:Adult; D004715:Endometriosis / Q000150:complications* / Q000473:pathology; D005184:Fallopian Tube Diseases / Q000150:complications* / Q000473:pathology; D005260:Female; D006801:Humans; D010049:Ovarian Diseases / Q000150:complications* / Q000473:pathology; D016585:Vaginosis, Bacterial / Q000150:complications*