Home » Volumes » Volume 53 - 2020 » A Very Rare Case of Brucellosis-Related Tubo-ovarian Abscess

A Very Rare Case of Brucellosis-Related Tubo-ovarian Abscess

Handan Alay1, Fatma Kesmez Can1, Emsal Pınar Topdağı Yılmaz2

1Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Ataturk University, Erzurum, Turkey.2Department of Obstetrics and Gynecology, Faculty of Medicine, Ataturk University, Erzurum, Turkey.

DOI: 10.1590/0037-8682-0501-2019

A 30-year-old patient presented with persistent left inguinal pain, abdominal pain, and fever for 10 days. Abdominal examination revealed hepatomegaly, splenomegaly, and left lower quadrant and suprapubic region tenderness. An 8 cm diameter abscess was observed in abdominal ultrasonography (Figure 1). Pelvic computed tomography revealed a 69×41 mm abscess with intense inflammation in the surrounding mesenteric area extended up to the iliac vasculature (Figure 2). Brucella spp. was detected in a blood sample. The brucella tube agglutination test was found positive at 1/640. The patient had a history of consuming unpasteurized milk and milk products. Brucellosis was diagnosed based on clinical, laboratory, and radiological findings and the patient history. The patient received doxycycline (2×200 mg), rifampicin (1×600 mg), and trimethoprim-sulfamethoxazole (2×1) therapy. The fever decreased on the third day of treatment, and the abscess contracted (33×40 mm) after 14 days (Figure 3). The gynecologist did not plan surgery due to the clinical and laboratory response and the shrinkage of abscess with treatment.

Brucellosis, a zoonotic infection, is an important public health problem in many developing countries1. Tubo-ovarian abscess frequently exhibits an acute course together with genitourinary and systemic symptoms2. Brucellosis can affect many organs requiring a multidisciplinary approach for patient management. This etiology should be considered in differential diagnosis of patients with tubo-ovarian abscess in endemic regions.

FIGURE 1: Pelvic ultrasonography showing an 8 cm diameter abscess. 

FIGURE 2: Abdomino-pelvic computed tomography showing a 69×41 mm abscess adjacent to the iliac vascular structures. 

FIGURE 3: Shrinkage of the abscess on the 14th day of brucellosis treatment. 


1. Centers for Disease Control (CDC). Brucellosis Reference Guide 2017. https://www.cdc.gov/brucellosis/pdf/brucellosi-reference-guide.pdf (Accessed on May 23, 2019). [ Links ]

2. Bosilkovski M, Krteva L, Dimzova M, Kondova I. Brucellosis in 418 patients from the Balkan Peninsula: exposure-related differences in clinical manifestations, laboratory test results, and therapy outcome. Int J Infect Dis. 2007;11(4):342-7. [ Links ]

Received: October 25, 2019; Accepted: December 11, 2019

Corresponding Author: Dr. Handan Alay. email:alayhandan@gmail.com

Conflict of interest: The authors declare that there is no conflict of interest.