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Infectious Diseases in Obstetrics and Gynecology
Volume 11 (2003), Issue 1, Pages 45-51

Etiology of Persistent Tubo-Ovarian Abscess in Nairobi, Kenya

1Department of Obstetrics and Gynecology, University of Washington, Box 356460, Seattle, WA 98195-6460, USA
2Center for Microbiology Research, Kenya Medical Research Institute, Kenya
3Department of Medical Microbiology, University of Nairobi, Nairobi, Kenya
4Department of Medicine, University of Washington, WA, USA
5 Department of Obstetrics and Gynecology, Oregon Health Sciences University, Portland, OR, USA

Received 14 June 2002; Accepted 5 December 2002

Copyright © 2003 Hindawi Publishing Corporation. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Objective To study the microbial etiology of tubo-ovarian abscess (TOA).

Methods We recruited 11 women in Nairobi, Kenya who failed antibiotic therapy alone and required surgical drainage of a presumptive TOA. Pus from the nine abscesses and two pyosalpinges were collected and cultured for aerobic, facultative and anaerobic microorganisms.

Results Eleven women suspected of having a TOA were hospitalized and treated for a median of 6 days (range 3–14 days) prior to surgical drainage of the abscess. Nine (82%) specimens were culture positive. Aerobes were present in all nine specimens. Seven of the nine positive cultures (78%) were polymicrobial and five of the polymicrobial cultures contained both anaerobes and aerobes. Anaerobic Gram-negative bacilli (Prevotella sp., Porphyromonas sp. and Bacteroides sp., Escherichia coli ) and Streptococcus sp. ( S. viridans and S. agalactiae) were the most common microorganisms isolated. Neisseria gonorrhoeae and Chlamydia trachomatis were not isolated by culture or detected by polymerase chain reaction.

Conclusions In Kenya, persistent TOAs are associated with endogenous flora similar to that normally found in the gastrointestinal tract.