Infected endometriotic cysts: clinical characterization and pathogenesis

Although endometriotic cysts are common, the occurrence of infection in these lesions has not been reported. Of 510 consecutive endometriotic cysts diagnosed at New York University Medical Center between 1965 and 1979, eleven had pathologically confirmed evidence of infection. These patients were nulliparous and had a mean age of 34.7 years at time of diagnosis and without long histories of endometriosis or pelvic infection. All were anemic. Six patients underwent total abdominal hysterectomy and bilateral salpingo-oophorectomy, and five patients were treated with conservative surgery. The morbidity of both groups was similar. The latter had a poor prognosis for fertility. Infected endometriotic cysts demonstrate a strong association with concomitant tubal infection and a weaker association with antecedent hysterosalpingography.