Repeated recurrence with antibiotic treatment requiring adnexal resection: a case of ovarian abscess with endometrial cyst after oocyte retrieval

Taishi Ide, Yoshinobu Shintani, Maiko Sugitani, Reiko Takeuchi, Yasuko Koganemaru, Rika Egami, Yoshitsugu Watanabe, Masao Fukuhara
In: JAPANESE JOURNAL OF GYNECOLOGIC AND OBSTETRIC ENDOSCOPY · 2024 · vol. 39(2) , pp. 34–38 · doi:10.5180/jsgoe.39.2_34 · W4390968523
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⚙ AI-generated summary by claude@2026-06, 2026-06-13 ⓘ

A patient with endometrial cysts experienced recurrent ovarian abscesses and peritonitis after oocyte retrieval, requiring multiple antibiotic treatments and ultimately adnexal resection.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-13 · read from full text ⓘ

This paper reports a 37-year-old nulligravid patient with infertility and endometrial cysts who developed tubo-ovarian abscess after oocyte retrieval, presenting on day 9 with abdominal distention and fever and being diagnosed with ovarian enlargement and peritonitis. She was treated with meropenem and initially discharged on day 36 after improvement, but experienced two subsequent flare-ups requiring readmission and repeat antibiotics, with a total hospital stay of 80 days and no sustained improvement. She was diagnosed with refractory left TOA after transfer to another hospital, where surgery revealed severe intra-abdominal adhesions and she ultimately underwent left adnexectomy via laparotomy after initial laparoscopy. This paper is centrally about endometriosis — it specifically describes an ovarian abscess associated with an endometrial (endometriosis) cyst developing after oocyte retrieval and antibiotic recurrence.

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Abstract

Tubo-ovarian abscess (TOA) is a severe pelvic inflammatory disease and a possible complication of oocyte retrieval in patients with endometrial cysts. A 37-year-old nulligravida with infertility complicated by endometrial cysts had oocyte retrieval performed at a fertility clinic. On Day 9 after retrieval, she developed abdominal distention and fever, and was admitted to an emergency hospital with a diagnosis of ovarian enlargement and peritonitis. Antibiotics (meropenem) were administered, and she was discharged on Day 36 after symptoms improved. Following this, she experienced two flare-ups and was re-admitted to the hospital and treated with the same antibiotic. Despite a total hospital stay of 80 days, no improvement was seen, and she was transferred to our hospital. She was diagnosed with refractory left TOA, and underwent laparoscopic surgery, revealing strong intra-abdominal adhesions. Thereafter, she was shifted to an open laparotomy and underwent a left adnexectomy. In suspected cases of TOA, appropriate treatment should be given at the right time.
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症例報告 抗生剤治療で再発を繰り返し最終的に付属器切除を要した採卵後の子宮内膜症性嚢胞膿瘍の一例 2024 年 39 巻 2 号 p. 34-38 詳細 抄録 Tubo-ovarian abscess (TOA) is a severe pelvic inflammatory disease and a possible complication of oocyte retrieval in patients with endometrial cysts. A 37-year-old nulligravida with infertility complicated by endometrial cysts had oocyte retrieval performed at a fertility clinic. On Day 9 after retrieval, she developed abdominal distention and fever, and was admitted to an emergency hospital with a diagnosis of ovarian enlargement and peritonitis. Antibiotics (meropenem) were administered, and she was discharged on Day 36 after symptoms improved. Following this, she experienced two flare-ups and was re-admitted to the hospital and treated with the same antibiotic. Despite a total hospital stay of 80 days, no improvement was seen, and she was transferred to our hospital. She was diagnosed with refractory left TOA, and underwent laparoscopic surgery, revealing strong intra-abdominal adhesions. Thereafter, she was shifted to an open laparotomy and underwent a left adnexectomy. In suspected cases of TOA, appropriate treatment should be given at the right time. © 2024 日本産科婦人科内視鏡学会

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