eMedicine Specialties > Obstetrics and Gynecology > Infections

Oophoritis: Differential Diagnoses & Workup

Author: Arthur T Ollendorff, MD, Associate Professor of Clinical Obstetrics and Gynecology, Residency Program Director, Department of Obstetrics and Gynecology, University of Cincinnati College of Medicine; Chief of Gynecology, Veterans Affairs Medical Center, Cincinnati
Contributor Information and Disclosures

Updated: Aug 14, 2007

Differential Diagnoses

Adnexal Tumors
Ectopic Pregnancy
Appendicitis
Gastroenteritis, Bacterial
Cystitis, Nonbacterial
Gastroenteritis, Viral
Diverticulitis
Mesenteric Lymphadenitis

Other Problems to Be Considered

Adnexal torsion

Workup

Laboratory Studies

  • Elevation of the white blood cell (WBC) count to more than 10,000/µL is a nonspecific indicator of infection; however, the count may be within reference ranges soon after onset.
  • Urinalysis is used to exclude cystitis.
  • Urine pregnancy testing is used to exclude ectopic pregnancy.
  • Wet preparation of cervical discharge shows numerous WBCs and bacteria.
  • Cervical cultures for gonococcal and chlamydial species are used to help exclude, diagnose, and treat infection with these organisms. Immediate results will not be available.

Imaging Studies

  • Pelvic ultrasonography may be needed if the patient cannot tolerate a thorough palpation of the adnexa because of pain. An ultrasonographic examination excludes the presence of a tubo-ovarian abscess (TOA). However, if a TOA is not present, ultrasonography will probably not be helpful.

Other Tests

  • Diagnostic laparoscopy is the definitive test. The diagnosis is usually made clinically.
  • Perform serologies for hepatitis B virus, hepatitis C virus, syphilis, and HIV, since these can be found in patients engaging in high-risk sexual behaviors.

Histologic Findings

Surgical evaluation may reveal an abscess involving the fallopian tubes and ovaries.

More on Oophoritis

Overview: Oophoritis
Differential Diagnoses & Workup: Oophoritis
Treatment & Medication: Oophoritis
Follow-up: Oophoritis
References
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References

  1. Beigi RH, Wiesenfeld HC. Pelvic inflammatory disease: new diagnostic criteria and treatment. Obstet Gynecol Clin North Am. Dec 2003;30(4):777-93. [Medline].

  2. Centers for Disease Control. 2006 Guidelines for Treatment of Sexually Transmitted Diseases. MMWR. 2006;55(RR11):1-94. [Full Text].

  3. Grimes DA. Deaths due to sexually transmitted diseases. The forgotten component of reproductive mortality. JAMA. Apr 4 1986;255(13):1727-9. [Medline].

  4. Ness RB, Trautmann G, Richter HE, et al. Effectiveness of treatment strategies of some women with pelvic inflammatory disease: a randomized trial. Obstet Gynecol. Sep 2005;106(3):573-80. [Medline].

  5. Reed SD, Landers DV, Sweet RL. Antibiotic treatment of tuboovarian abscess: comparison of broad- spectrum beta-lactam agents versus clindamycin-containing regimens. Am J Obstet Gynecol. Jun 1991;164(6 Pt 1):1556-61; discussion 1561-2. [Medline].

  6. Soper DE. Surgical considerations in the diagnosis and treatment of pelvic inflammatory disease. Surg Clin North Am. Oct 1991;71(5):947-62. [Medline].

  7. Stenchever M, Droegemueller W, Herbst A. Comprehensive Gynecology. 4th ed. Mosby Year Book; 2006:708-731.

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Further Reading

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Keywords

oophoritis, pelvic inflammatory disease, PID, tubo-ovarian abscess, TOA, ectopic pregnancy, infertility, chronic pelvic pain, Gonorrhea, Chlamydia, inflammation of the ovary, infection of the ovaries, sterilization

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Contributor Information and Disclosures

Author

Arthur T Ollendorff, MD, Associate Professor of Clinical Obstetrics and Gynecology, Residency Program Director, Department of Obstetrics and Gynecology, University of Cincinnati College of Medicine; Chief of Gynecology, Veterans Affairs Medical Center, Cincinnati
Arthur T Ollendorff, MD is a member of the following medical societies: American College of Obstetricians and Gynecologists and American Public Health Association
Disclosure: Nothing to disclose.

Medical Editor

Ronald Levine, MD, Director, Section of Gynecologic Endoscopy, Professor, Department of Obstetrics and Gynecology, University of Louisville School of Medicine
Ronald Levine, MD is a member of the following medical societies: American Academy of Allergy Asthma and Immunology, American College of Obstetricians and Gynecologists, American Medical Association, and Society of Laparoendoscopic Surgeons
Disclosure: Nothing to disclose.

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: Nothing to disclose.

Managing Editor

Antonio V Sison, MD, FACOG, Program Director, Department of Obstetrics and Gynecology, Robert Wood Johnson University Hospital
Antonio V Sison, MD, FACOG is a member of the following medical societies: American College of Obstetricians and Gynecologists and Association of Professors of Gynecology and Obstetrics
Disclosure: Nothing to disclose.

CME Editor

Frederick B Gaupp, MD, Consulting Staff, Department of Family Practice, Assumption Community Hospital
Frederick B Gaupp, MD is a member of the following medical societies: American Academy of Family Physicians
Disclosure: Nothing to disclose.

Chief Editor

Michel E Rivlin, MD, Associate Professor, Coordinator, Quality Assurance/Quality Improvement, Department of Obstetrics and Gynecology, University of Mississippi School of Medicine
Michel E Rivlin, MD is a member of the following medical societies: American College of Obstetricians and Gynecologists, American Medical Association, Mississippi State Medical Association, and Royal College of Surgeons of Edinburgh
Disclosure: Nothing to disclose.

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