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Chorioamnionitis and sternoclavicular septic arthritis after drainage of Bartholin gland abscess
Jeannie C Kelly1, Xibei Jia, Tine Vindenes
1Departments of Obstetrics and Gynecology and Geographic Medicine and Infectious Diseases, Tufts Medical Center, and Tufts University, School of Medicine, Boston, Massachusetts.
Background:
Complications after drainage of Bartholin gland abscesses in pregnancy are rare.
Case:
A 29-year-old primigravid at 35 weeks of gestation with dichorionic-diamniotic twins underwent Bartholin gland abscess drainage. Afterward, she reported shoulder pain and became febrile. Examination revealed maternal and fetal tachycardia with abdominal tenderness consistent with chorioamnionitis, and she underwent delivery. Blood cultures grew Escherichia coli, and antibiotics were begun. Her shoulder pain worsened, and examination demonstrated inflammation over the sternoclavicular joint. Fluid aspirate of this joint grew E coli. She experienced improvement after aspiration and was discharged home on antibiotics.
Conclusion:
Although rare, severe consequences can result from Bartholin gland abscesses in pregnant patients, including sepsis and septic arthritis. Close clinical follow-up should be considered in pregnant patients undergoing abscess drainage.
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