title: Comparative study of the clinical features of patients with a tubo-ovarian abscess and patients with severe pelvic inflammatory disease.
abstract: OBJECTIVE
  To determine the clinical characteristics that indicate the presence of tubo-ovarian abscess (TOA) among patients with severe pelvic inflammatory disease (PID).
  
  
  METHODS
  An observational cohort study was performed from October 2011 to March 2013. The study included all patients with a diagnosis of TOA and PID admitted to a university hospital in Mexico. A complete medical history and physical examination were performed, and laboratory studies were reviewed. A logistic regression analysis was performed on variables with statistical significance.
  
  
  RESULTS
  Overall, 26 patients with PID and TOA (TOA group) and 26 with PID without TOA (PID group) were included in the study. Significant differences between patients with TOA and PID were found with regard to the patients' age (39.3years vs 33.1years; P=0.04), educational level (only elementary, 13 [50%] vs 5 [19%]; P=0.14), presentation with fever (23 [88%] vs 16 [62%]; P=0.025), white blood cell count (21.8×10(9)/L vs 14.9×10(9)/L; P<0.001), number of deliveries (2.2 vs 1.1; P=0.01), and presence of diarrhea (16 [62%] vs 5 [19%]; P<0.001). The triad of fever, leukocytosis, and diarrhea was positively related to the presence of TOA.
  
  
  CONCLUSIONS
  The triad of fever, leukocytosis, and diarrhea should alert clinicians to the possibility of TOA formation in patients with PID.
authors.affiliation: University Center for Reproductive Medicine, Universidad Autónoma de Nuevo León University Hospital, Monterey, Nuevo León, Mexico. Electronic address: luissordia@telmexmail.com.
authors.forename: Luis H
authors.initials: LH
authors.lastname: Sordia-Hernández
authors.affiliation: University Center for Reproductive Medicine, Universidad Autónoma de Nuevo León University Hospital, Monterey, Nuevo León, Mexico.
authors.forename: Laura G
authors.initials: LG
authors.lastname: Serrano Castro
authors.affiliation: University Center for Reproductive Medicine, Universidad Autónoma de Nuevo León University Hospital, Monterey, Nuevo León, Mexico.
authors.forename: María O
authors.initials: MO
authors.lastname: Sordia-Piñeyro
authors.affiliation: University Center for Reproductive Medicine, Universidad Autónoma de Nuevo León University Hospital, Monterey, Nuevo León, Mexico.
authors.forename: Arturo
authors.initials: A
authors.lastname: Morales Martinez
authors.affiliation: University Center for Reproductive Medicine, Universidad Autónoma de Nuevo León University Hospital, Monterey, Nuevo León, Mexico.
authors.forename: Mary C
authors.initials: MC
authors.lastname: Sepulveda Orozco
authors.affiliation: University Center for Reproductive Medicine, Universidad Autónoma de Nuevo León University Hospital, Monterey, Nuevo León, Mexico.
authors.forename: Geraldina
authors.initials: G
authors.lastname: Guerrero-Gonzalez
mesh_terms: D000038:Abscess / Q000150:complications / Q000175:diagnosis*; D000293:Adolescent; D000328:Adult; D000367:Age Factors; D015331:Cohort Studies; D003967:Diarrhea / Q000209:etiology; D005184:Fallopian Tube Diseases / Q000150:complications / Q000175:diagnosis*; D005260:Female; D005334:Fever / Q000209:etiology; D006801:Humans; D007964:Leukocytosis / Q000209:etiology; D016015:Logistic Models; D008800:Mexico; D008875:Middle Aged; D010049:Ovarian Diseases / Q000150:complications / Q000175:diagnosis*; D000292:Pelvic Inflammatory Disease / Q000150:complications / Q000175:diagnosis*; D055815:Young Adult
keywords: Leukocytosis; Pelvic inflammatory disease; Tubo-ovarian abscess