emDOCs Podcast / Episode 68 - December 20, 2022 -By Brit Long
Key Points:
- Key risk factors to consider for TOA include PID, presence of IUD, multiple sexual partners, DM, and immunocompromised states.
- History and physical examination are non-specific; TOA should be considered in the female patient with lower abdominal pain and fever/chills.
- Elevations in CRP can be a predictor of more severe disease though elevations in inflammatory markers are non-specific.
- US and CT can be used for diagnosis, though CT has higher sensitivity.
- Management includes consultation with the OBGYN specialist and administration of parenteral antibiotics covering sexually transmitted infections and polymicrobial gastrointestinal bacteria.
- Factors associated with failed medical management include larger abscess size or bilateral abscesses, fever, older age, parity, and significantly elevated inflammatory markers on laboratory evaluation.