Tubo-ovarian abscess caused by Streptococcus pneumoniae

A 46-year-old black woman underwent exploratory surgery for evaluation of a tender mass in her abdomen. During the exploratory surgery bilateral tubo-ovarian abscesses ruptured. Specimens from both tubes and from the wall of the abscesses contained bacteria seen on the Brown-Hopps tissue gram stain. The bacteria were gram-positive, lancet-shaped diplococci characteristic of Streptococcus pneumoniae. Immunoperoxidase stains confirmed the identification of the organism as S pneumoniae.