Bartholin Gland: Abscess/Infection

Introduction

• Description: An infection may occur in one or both Bartholin glands, resulting in swelling and/or abscess formation. Usually, the process is unilateral and marked by pain and swelling. Systemic symptoms are minimal except in advanced cases.

• Prevalence: 2% of adult women develop infection or enlargement of one or both Bartholin glands. Abscesses are almost three times more common than cysts.

• Predominant Age: Of all Bartholin gland infections, 85% occur during the reproductive years.

• Genetics: No genetic pattern.

Etiology and Pathogenesis

• Causes: Infection by Neisseria gonorrhoeae (80%), secondary infection by other organisms (eg, Escherichia coli). Methicillin-resistant Staphylococcus aureus (MRSA) is emerging as a more common infectious agent.

• Risk Factors: Exposure to sexually transmitted infection (STI), trauma.

Signs and Symptoms

• Cystic, painful swelling of the labia in the area of the Bartholin gland (at 5 and 7 o’clock positions on the vulva) developing rapidly over 2–4 days; the size of cysts measure 3–6 cm but can grow to >8 cm. The cyst will be warm with overlying erythema and induration.

• Fever and malaise (20% of patients).

Diagnostic Approach