Problems of ovaries and vagina

Ovarian infection

The ovaries and fallopian tubes ( Figs. 141 and 142 ), which carry eggs from the ovaries to the uterus, might become infected, commonly with Mycoplasma genitalium , or with the bacteria ( Neisseria gonorrhea ) that cause gonorrhea or by other infectious agents, such as Chlamydia trachomatis. This is sometimes called pelvic inflammatory disease (PID). Symptoms include abdominal pain in the lower quadrants (greatest on the side of the affected ovary), fever, shaking chills, nausea, vomiting, and weakness. Occasionally, the patient will complain of a yellow-greenish vaginal discharge. If you suspect an infection, take the patient to a hospital immediately, where the PID patient will receive at least one medication administered by injection. If more than 24 hours will pass before a doctor can be reached, the victim should be treated with azithromycin 1 g by mouth single dose or doxycycline 100 mg two times a day for 14 days. Add to either of these metronidazole 500 mg by mouth twice a day for 2 weeks. If these are not available, then use tetracycline 500 mg four times a day or amoxicillin–clavulanate 500 mg two to three times per day for 14 days (doxycycline and tetracycline are effective against Chlamydia ). Yet another drug combination is a 14-day oral course of metronidazole 500 mg twice a day plus one of the following: levofloxacin 500 mg once a day or moxifloxacin 400 mg once a day or ofloxacin 400 mg twice a day. To reiterate, if you suspect gonorrhea (can occur at same time as other infections and should often be suspected), bring the patient to a health care professional promptly for an injection of ceftriaxone (or another cephalosporin type of medication) while administering the medications for chlamydial infection. Away from professional medical care, if more than 24 hours will pass before a doctor can be reached and supplies are limited, to treat the gonorrhea, albeit suboptimally, administer cefixime 800 mg orally as a single dose.