A Rare Case of Tubo-Ovarian Abscess by Enterococcus SPP, Following Intrauterine Insemination

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Background: Tubo-ovarian abscess (TOA) is one of the most serious infections and one of the important and life-threatening complications of the pelvic inflammatory disease. This infection with intrauterine insemination (IUI) is rare. Herein, we reported a case of tubo-ovarian abscess with enterococci after IUI procedure. Case: A 38-year-old lady G2AB1L1 referred to our center with acute abdominal pain and fever two weeks after IUI with the diagnosis of the tubo-ovarian abscess. After treatment with intravenous broad-spectrum antibiotics and repeated drainage under ultrasonographic guide, she was still febrile after 20 days but had no tenderness in the abdominal test. Therefore, laparoscopy and bilateral salpingo-oophorectomy were done for the patient, and due to positive abscess culture for Enterococci spp., linezolid was started for the patient. The woman became afebrile on the eighth postoperative day, and after two weeks of antibiotic therapy was discharged from hospital in good condition. Conclusion: In conclusion, we described a rare case of TOA after IUI procedure by rare colonies of Enterococcus spp., which was not managed with antibiotics and repeated evacuation alone. We have demonstrated that abscesses can be successfully eradicated with surgery and concomitant antibiotic therapy. The clinician must be aware of the potential infectious morbidity following the IUI procedure, the importance of clean catheter use, early diagnosis, and intervention to minimizing morbidity.