ImportantQuestions to Include When Interviewing a Patient with This Issue
Atubovarian abscess denotes a sack filled pus that forms after aninfection in the ovary or fallopian tube. It is often caused by thepelvic inflammatory disease (PID) (Dessein et al., 2015). In such away, a medical practitioner can ask the following questions to apatient suffering from this disease:
Do you occasionally experience painful episodes around the abdomen?
Is there abnormal rise or fall in body temperature?
Have you ever been diagnosed with a sexually transmitted infection before?
Do you use any birth control method?
TheClinical Findings That May be Present in a Patient with This Issue
Theclinical findings by a medical practitioner in a patient with thisissue include a sharp pain in the abdomen, fever, recurrent chills,and a purulent vaginal discharge. However, not all women experiencefever, as some of them will feel a slight increase in their bodytemperatures at night. Continuous abdominal pain may also be presentin the patient(Kim, Lee, Yoon, & Han, 2013).The patient may also experience a change in their bowel movements.Tenderness in the patient’s lower abdomen is another criticalobservation.
DiagnosticStudies That Should be Ordered on This Patient and Why
Thedoctor should do a blood and urine test to check for pregnancy or ifanother ailment is causing the symptoms. An ultrasound may also bedone on the patient to get a clear image of the presence of theabscesses and their size (Kinayet al., 2016).Laparoscopy can also be used to look directly into the fallopian tubeand ovaries for the presence of the abscesses.
ThePrimary Diagnosis and Three Differential Diagnoses for This Patientand Reasoning for Each
Theprimary diagnosis will be the presence of an abscess in the ovariesor fallopian tube of the patient. The doctor may find somedifferential diagnoses including the following:
Urinary tract infection which implies that the patient is not observing hygienic.
Appendicitis which suggests that the appendix is blocked, calling for a swift medical attention.
Endometritis which indicates a history miscarriage or abortion hence the doctor should recommend a birth control program for the patient.
TheManagement Plan for This Patient Including Pharmacologic Therapies,Tests, Patient Education, Referrals, and Follow-Ups
Thepatient should be properly tested to ensure that the condition isbrought under control. Direct inpatient surveillance for at least 24hours is recommended. The patient should be immediately givenantibiotics like doxycycline 100mg orally every 12 hours orampicillin 3g every six hours for two weeks (Goodwin, Fleming, &Dumont, 2013). The doctor should be keen to look out for signs ofimprovement in the patient like reduction in abdominal pain and whiteblood cells being normalized. However, if the patient does not showany signs of progress, surgery may be ordered to drain or remove theabscess.
Thepatient may be referred to a professional for a hysterectomy to beconducted if the abscess spreads from the ovary. The doctor shouldthen advise the patient to refrain from sexual activities during thetreatment period and ensure that the partner is tested for sexuallytransmitted diseases. Consequently, the patient should be dischargedfrom the hospital in case of a positive response to antibiotics orafter recovering from surgeries(Kinayet al., 2016). A follow-up is crucial after five days of discharge,accompanied by a computerized tomography (CT) scan to confirm thesuccess of the treatment.
Dessein,R., Giraudet, G., Marceau, L., Kipnis, E., Galichet, S., Lucot, J.P., & Faure, K. (2015). Identification of sexually transmittedbacteria in tubo-ovarian abscesses through nucleic acidamplification. Journalof Clinical Microbiology, 53(1),357-359.
Goodwin,K., Fleming, N., & Dumont, T. (2013). Tubo-ovarian abscess invirginal adolescent females: A case report and review of theliterature. Journalof Pediatric and Adolescent Gynecology, 26(4),99-102.
Kim,J. W., Lee, W. S., Yoon, T. K., & Han, J. E. (2013). Termdelivery following tuboovarian abscess after in vitro fertilizationand embryo transfer. AmericanJournal of Obstetrics and Gynecology, 208(5),3-6.
Kinay,T., Unlubilgin, E., Cirik, D. A., Kayikcioglu, F., Akgul, M. A., &Dolen, I. (2016). The value of ultrasonographic tubo‐ovarianabscess morphology in predicting whether patients will requiresurgical treatment. InternationalJournal of Gynecology & Obstetrics, 135(1),77-81.