Bilateral Tuboovarian Abscess Due to Salmonella paratyphi A: A Case Report and Review of Literature

Local abscess formation may occur as a complication of any Salmonella infection by either hematogenous or lymphatic spread but a tuboovarian site of Salmonella infection is rare. Mostly,predisposing factors such as ovarian abnormalities like dermoid cyst, endometrioma, cystadenoma, or simple cyst are present where hematogenously disseminated Salmonella tend to localize. A case of bilateral tuboovarian abscess due to Salmonella paratyphi A is being reported in a 36-year-old woman having multicystic ovaries to highlight the unusual presentation of this organism. In countries like India, where Salmonella infections are endemic, differential diagnosis of Salmonella should always be kept in mind by the clinicians while dealing with the tuboovarian abscesses because there is a possibility of Salmonella infection at aberrant sites, especially in patients with history of persistent fever or gastroenteritis or any preexisting abnormality that makes the tissue or organ vulnerable. (Infect Dis Clin Pract 2008;16:408Y410) Infections caused by Salmonella remain an important public health problem, particularly in developing countries. Morbidity and mortality attributable to Salmonella infections are increasing with the emergence and worldwide spread of Salmonella strains that are resistant to most routine antibiotics. Bacteremia is a constant feature of enteric fever. Occasionally, dissemination of bacilli throughout the body results in establishment of 1 or more localized foci of persisting infection especially where a preexisting abnormality has made a tissue or organ vulnerable. Isolation of Salmonella species, with variety of clinical syndromes from aberrant sites, where they are hardly expected has been reported. However, tuboovarian abscess (TOA) is a rare manifestation of Salmonella infection. We report a case of TOA from which Salmonella paratyphi A was isolated.