Many patients with a tubo-ovarian abscess can be successfully treated with antibiotics. However, some patients require surgical drainage or resection. A number of findings can help to identify a patient who may fail conservative therapy.
Patient selection: tubo-ovarian abscess
Surgical management: laparoscopy, CT-guided needle drainage, laparotomy
Predictors for failure of antibiotic therapy (and for need for an invasive procedure):
(1) larger abscess size (> 6 cm)
(2) elevated serum CRP concentration on admission, with level rising during antibiotic therapy
Cutoffs for serum CRP on admission:
(1) > 143 mg/L (Akselim)
(2) > 49 mg/L (Ribak)
Other predictors:
(3) older age (> 34.3 years Hwang, > 41.5 years Akselim)
(4) overweight or obese
(5) elevated serum CA125
(6) higher WBC count
(7) elevated ESR on admission (> 45 mm/h Hwang)
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Specialty: Infectious Diseases
