A 20 year old G3P0 woman presents with left lower abdominal pain and vaginal discharge. She says she sometimes feels warm at night but hasn't had a marked fever. "I've had PID in the past, and this just isn't the same," she says. You are unable to do a complete pelvic exam because of significant adnexal tenderness. Because of this, you order pelvic imaging which is shown above. A CBC shows leukocytosis, and pregnancy test is negative. She undergoes surgery and cultures grow out a polymicrobial mix of E.coli, aerobic streptococci, Bacteroides, and Prevotella.
Challenge: What is the diagnosis?
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This is a tuboovarian abscess. The transvaginal ultrasound of the left adnexa shows a complex solid and cystic mass.
Source: UpToDate.
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