Gonococcal pelviperitonitis: a diagnostic challenge

Authors

  • M.J. Puente Luján Servicio de Ginecología y Obstetricia. Hospital Universitario Miguel Servet. Zaragoza.
  • M. Chóliz Ezquerro Servicio de Ginecología y Obstetricia. Hospital Universitario Miguel Servet. Zaragoza.
  • A. Espiau Romera Servicio de Ginecología y Obstetricia. Hospital Universitario Miguel Servet. Zaragoza.
  • J. Navarro Sierra Servicio de Ginecología y Obstetricia. Hospital Universitario Miguel Servet. Zaragoza.
  • M. Fernández Esgueva Servicio de Microbiología. Hospital Universitario Miguel Servet. Zaragoza.
  • I. Negredo Quintana Servicio de Ginecología y Obstetricia. Hospital Universitario Miguel Servet. Zaragoza.

DOI:

https://doi.org/10.23938/ASSN.0931

Keywords:

Gonococcal pelviperitonitis, Pelvic inflammatory disease, Acute abdomen, Differential diagnosis

Abstract

Neisseria gonorrhoeae is the second most common etiological agent of pelvic inflammatory disease and is currently underdiagnosed due to its asymptomatic presentation in 50% of cases. When the disease presents, it may appear in the form of acute abdomen and normal imaging tests, making it a major diagnostic challenge.

We present four cases of acute gonococcal peritonitis. The main symptom was acute abdominal pain, and both the gynecological examination and complementary tests showed normal results. The only notable finding from the laparoscopy was the existence of purulent ascitic fluid. The results of the anatomical and pathological tests were all normal. Endocervical and ascitic fluid culture showed infection with N. gonorrhoeae, and in one case, concomitant infection with Chlamydia trachomatis. The definitive treatment applied was intravenous antibiotic therapy.

When a sexually active young woman is diagnosed with peritonitis that has no apparent cause, it is important to rule out sexually transmitted diseases.

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Published

2021-04-28

How to Cite

Puente Luján, M., Chóliz Ezquerro, M., Espiau Romera, A., Navarro Sierra, J., Fernández Esgueva, M., & Negredo Quintana, I. (2021). Gonococcal pelviperitonitis: a diagnostic challenge. Anales Del Sistema Sanitario De Navarra, 44(1), 107–112. https://doi.org/10.23938/ASSN.0931

Issue

Vol. 44 No. 1 (2021): January - April 2021

Section

Clinical notes

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