绝经后女性宫内节育器相关卵巢脓肿术后继发脑脓肿一例

A Case of Brain Abscess Secondary to Intrauterine Device-Related Ovarian Abscess in A Postmenopausal Woman

脑脓肿是卵巢脓肿的罕见并发症,在卵巢脓肿术后,即使经过抗感染治疗,仍可发生。报告1例57岁女性,在当地基层医院行宫内节育器取出术后出现排尿障碍伴下腹痛,考虑卵巢脓肿,行卵巢脓肿切除术。术后1个月患者出现持续性高热、头痛,磁共振成像提示为脑脓肿,给予抗感染、降低颅内压、纠正低白蛋白血症等治疗,病情稳定后出院。患者定期门诊复查,出院8个月后影像结果提示痊愈。结合该病例,总结卵巢脓肿术后继发脑脓肿的发病机制、临床表现、诊疗方法及预防。

Brain abscess as a rare complication of ovarian abscess can occur even after anti-infective treatment following ovarian abscess surgery.We report a case of a 57-year-old postmenopausal woman who developed urinary difficulty and lower abdominal pain after intrauterine device removal in a local hospital.She was diagnosed with ovarian abscess and underwent ovarian abscess resection.One month post-surgery,the patient presented with persistent high fever and headache.She was diagnosed as a brain abscess by magnetic resonance imaging,and treated by anti-infection,intracranial pressure reduction,and correction of hypoalbuminemia.The patient was discharged after her condition stabilized.Regular outpatient follow-ups were conducted,and imaging results indicated the complete recovery after eight months of discharge.We summarize the pathogenesis,clinical manifestations,diagnosis,treatment and prevention of secondary brain abscess following ovarian abscess surgery.