eMedicine Specialties > Obstetrics and Gynecology > Infections

Oophoritis

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

Introduction

Background

Oophoritis (ie, inflammation of the ovary) is an uncommonly used term for pelvic inflammatory disease (PID). This is an ascending infection of the ovaries and a major cause of female infectious morbidity, ectopic pregnancy, and sterilization. Oophoritis is a clinically diagnosed disease that must be carefully distinguished from other causes of abdominal pain.

Pathophysiology

Infection ascends from bacterial colonization of the cervix and extends to the uterus, fallopian tubes, and ovaries. Gonorrhea and Chlamydia species are typically colonized from the cervix in cases of oophoritis, but these pathogens are rarely isolated in ovarian tissue. These organisms instead facilitate infection of the adnexa by other bacteria. If left untreated, an abscess may form around the fallopian tubes and ovaries, a condition known as a tubo-ovarian abscess (TOA).

Frequency

United States

One million cases are reported each year.

International

Worldwide incidence and prevalence rates are unknown.

Mortality/Morbidity

In the United States, the Centers for Disease Control and Prevention (CDC) estimate that 150 women die each year and 100,000 women become infertile due to oophoritis. The other major morbidities are an increased risk of ectopic pregnancy and chronic pelvic pain.

Age

Oophoritis most commonly occurs in women younger than 25 years. When oophoritis occurs in postmenopausal women, it is usually associated with an underlying gynecologic malignancy.

Clinical

History

  • Abdominal pain
  • Pelvic pain
  • Vaginal discharge
  • Dyspareunia
  • Fever
  • Chills
  • Nausea/vomiting

Physical

  • Temperature greater than 38°C
  • Abdominal tenderness in lower quadrants
  • Possible rebound tenderness on pelvic examination
  • Mucopurulent discharge
  • Cervical motion tenderness
  • Adnexal tenderness
  • Adnexal mass (if a tubo-ovarian abscess is present)

Causes

  • Unprotected sexual intercourse
  • Multiple sexual partners
  • High-risk sexual behavior
  • Immunosuppression
  • Recent instrumentation of genital tract (endometrial biopsy, intrauterine device [IUD] placement)
  • Gynecologic malignancy (in postmenopausal women)

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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