Bilateral Tubo-Ovarian Abscess Colonized by Enterococcus in a Woman With Systemic Lupus Erythematosus and End-Stage Renal Disease: A Case Report

Tubo-ovarian abscess (TOA) is an inflammatory process involving the fallopian tubes and the ovary. It is one of the complications occurring in acute pelvic inflammatory disease (PID). Intrauterine device (IUD) insertion, history of a prior PID, reproductive age, and multiple sexual partners are the most common risk factors for TOA. The diagnosis of bilateral TOA is rare. Commonly isolated organisms from the abscess include Neisseria (N.) gonorrhoeae, Escherichia​​​​​​​ (E.) coli, and/or normal flora of the vagina and cervix. Treatment of the abscess should be started as soon as possible with broad-spectrum antibiotics as recommended by the Centers for Disease Control and Prevention (CDC) and drainage of the pelvic collection. Here, we present a complicated case in a middle-aged, sexually inactive woman with bilateral TOA colonized by Enterococcus faecalis. She is a known case of systemic lupus erythematosus (SLE) complicated by end-stage renal disease (ESRD), along with other co-morbidities. We summarize, in our case report, the experience of a successful treatment for this condition.