title: Tubo-Ovarian Abscess Caused by Candida Albicans in an Obese Patient.
abstract: BACKGROUND
  Tubo-ovarian abscess (TOA) arises in most cases from pelvic infection. Appropriate treatment includes use of antimicrobials and, especially in patients with increased BMI, drainage of the contents.
  
  
  METHODS
  A 44-year-old morbidly obese woman (BMI 72) had a persistent TOA despite receiving antibiotic treatment for four months. She had no history of diabetes, and denied being sexually active. Imaging demonstrated a pelvic abscess of 14.9 × 8.9 × 11.1 cm. Successful percutaneous drainage was performed yielding purulent material which grew Candida albicans. The patient recovered after drainage of the abscess and the addition of fluconazole to her antimicrobials. She had no apparent risk factor for acquiring such an opportunistic infection, other than her morbid obesity.
  
  
  CONCLUSIONS
  Because morbid obesity may confer a relative immunodeficiency, morbidly obese patients may develop unusual infections such as opportunistic fungal abscesses.
authors.affiliation: Department of Obstetrics and Gynaecology, McGill University Health Centre, Montreal QC.
authors.forename: Valerie
authors.initials: V
authors.lastname: To
authors.affiliation: Department of Obstetrics and Gynaecology, McGill University Health Centre, Montreal QC.
authors.forename: Joshua
authors.initials: J
authors.lastname: Gurberg
authors.affiliation: Department of Obstetrics and Gynaecology, McGill University Health Centre, Montreal QC.
authors.forename: Srinivasan
authors.initials: S
authors.lastname: Krishnamurthy
mesh_terms: D000038:Abscess / Q000382:microbiology* / Q000601:surgery; D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000935:Antifungal Agents / Q000627:therapeutic use; D002176:Candida albicans; D002177:Candidiasis / Q000175:diagnosis* / Q000188:drug therapy / Q000601:surgery; D004322:Drainage; D004359:Drug Therapy, Combination; D005260:Female; D015725:Fluconazole / Q000627:therapeutic use; D006801:Humans; D009767:Obesity, Morbid / Q000150:complications*; D010049:Ovarian Diseases / Q000188:drug therapy / Q000382:microbiology* / Q000601:surgery; D012488:Salpingitis / Q000188:drug therapy / Q000382:microbiology* / Q000601:surgery
chemical_list: D000900:Anti-Bacterial Agents; D000935:Antifungal Agents; D015725:Fluconazole
keywords: Candida albicans; drainage; female; morbid; obesity; opportunistic infection; pelvic infection