Management of Salmonella ovarian abscess in a patient with systemic lupus erythematosus

Objective: To report a patient with systemic lupus erythematosus (SLE) with persistent ovarian abscess infected with Salmonella. Design: Case report. Setting: Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital. Patient(s): A 35-year-old woman with a 10-year history of SLE had intermittent fever with chills that was refractory to empirical antibiotics. Intervention(s): Ceftriaxone was administered on the basis of blood culture showing Salmonella group B infection and was followed by image-guided drainage. Main Outcome Measure(s): Removal of pelvic abscess. Result(s): Right ovarian abscess persisted despite percutaneous drainage. Laparoscopic removal of the encapsulated abscess was performed, and she remained well during her 6-month follow-up. Conclusion(s): Appropriate administration of antibiotics is the mainstay treatment for Salmonella infection complicated with SLE. Any localized abscess after prolonged antibiotics should be treated with surgical debridement to ensure complete eradication of infection. Conservative surgery with use of laparoscopy is an option in skilled personnel. (Fertil Steril(R) 2009;92:391.e1-e3. (C) 2009 by American Society for Reproductive Medicine.)