Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0001577 (adnexitis)
 232 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Reported is a case of vesico-ovarian fistula in the right ovary of a 27- year-old woman. The development of fistulas between the bladder and ovary is an exceedingly rare occurrence; no recent cases have been described in the medical literature. In this case, the patient had worn an intrauterine pessary for contraceptive purposes for the preceding 18 months. She presented with dysuric symptoms and was misdiagnosed as having a urinary tract infection. Persistent microscopic hematuria prompted examination by urethrocystoscopy. Biopsy of the fistulous region showed hyperplastic and follicular chronic urocystitis with no malignant cells. The fistulous duct adhered to the parametrium and was surrounded by pelvioperitonitis. Treatment consisted of removal of the right adnexa, excision of the fistulous duct, and suturing of the bladder. The pessary was removed at the same time. Bacteriological examination revealed Staphylococcus epidermidis infection in the ovary and fistula as well as on the pessary. The histopathologic examination showed a fistulous suppurative inflammation of the right ovary and an ovarian abscess; also detected were granulocytic salpingitis and perisalpingitis. The patient's recovery was uneventful, with no complications. The adnexitis in this case appears attributable to the intrauterine device. As use of intrauterine pessaries becomes more widespread, a bladder-ovary route of inflammation should be considered, especially in women with discernible genital lesions with marked vaginal discharge.
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PMID:Vesico-ovarian fistula in suppurative ovarian inflammation and salpingitis. 229 29

Antibiotic use was evaluated retrospectively in 1229 patients of a university hospital (Basle, Switzerland). The frequency with which antibiotics were prescribed, the indication, duration of treatment, side-effects and clinical results were compared in relation to various subspecialities. 38.1% of medical, 36.4% of surgical and 24.4% of gynecological patients received one or more antibiotic during hospitalization. The main indications for antibiotic treatment were respiratory infection (57.8%) and urinary tract infections (21%) in medical patients, prophylaxis (38%) and urinary tract infections (23%) in surgery, and urinary tract infections (43%) and adnexitis or endometritis (23%) in gynecology. Amoxycillin or penicillin G were the first-line drugs for respiratory infection, cotrimoxazole for urinary tract infection and cefalothin or cefacetrile for surgical prophylaxis. Patients with endometritis or adnexitis usually received clindamycin in combination with an aminopenicillin. Aminoglycosides were employed in only 9.5% of antibiotic courses. Information on adverse reactions in the records was scanty, only generalized exanthem (13 cases) and nausea/vomiting (2 cases) being specifically mentioned. The therapeutic result was classified by the responsible physician as cure in 50.8% or definite improvement in 16.4% of patients. However, in 118 cases (29.7%) the contribution of antibiotics to the clinical outcome could not be evaluated retrospectively.
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PMID:[Use of antibiotics in hospitalized patients. Comparison of medical, surgical and gynecological units]. 720 74